Indications:
The interest of the biopsy should be carefully weighed before the risks.
This is thanks to a liver tissue sampling to know the liver condition, information that can be useful in case of chronic hepatitis or cirrhosis scalable.
Cons-indications:
cholestatic liver disease (obstruction of the bile duct blocking the functioning of the liver).
Patient on anticoagulation or aspirin.
platelets at a lower rate at 100 000Lmm3.
Hemostasis disorders: TCK (partial thromboplastin time) higher by more than 12 s to that of witnesses.
Technique:
The examination requires hospitalization for 24 hours.
The patient, fasting is placed in the left lateral position, under local anesthesia with Xylocaine.
The puncture is performed by fine needle disposable (Hépafix) in intercostal.
Sampling can be done blindly or under ultrasound or CT guidance.
The examination carried out, it will monitor pulse and blood pressure regularly to occult bleeding.
Results:
The levy, fixed in Bouin, is entrusted to the pathologist.
It will explore, through immunofluorescence methods, the existence of viral antigens through histological analysis, it will specify the type, nature of injuries, their extension and scalability: fibrosis, inflammation.
Incidents:
Morality varies from 0.01 to 0.1%, most often by intraperitoneal hemorrhage.
The most common incident is the pain of the right shoulder in 30% of cases, benign, relieved by non-salicylate analgesic.
The vagal is possible but passenger.
The bleeding is detected by clinical signs: change of pulse and fall in blood pressure, and biological: down more than 2 g / L of hemoglobin.
The puncture of other organs is rare: lung, colon, kidney, bladder or accidental realization of intrahepatic arteriovenous fistula.
Infection is exceptional.
Cost:
K10 + B75.
Practical advice:
The patient is asleep by his collaboration is essential: the absolute stillness provides better conditions for realization of the review and a lower risk. Otherwise, there is a risk of injury to a neighbor member upon movement, even minimal, of the patient.
