Percutaneous biopsy of malignant hepatic tumor in patients with bleeding tendency: Usefulness of gelfoamplugging up the biopsy track

ABSTRACT

PURPOSE: To plug the biopsy site in eight patients with coagulopathy who had undergone percutaneous liverbiopsy. To this end, gelfoam cartridge was used as a sealant. MATERIALS AND METHODS: Using an 18G Tru-Cut-typedisposible automated biopsy gun(Soo Ho Medi-tech, Seoul, Korea) and under US guidance, eight patients underwentpercutaneous liver biopsy. After the gun had fired, the biopsy specimen in the inner stylet was retrieved whilethe outer cannula was held in place ; the cannula was then used to plug the biopsy tracks with gelfoam, using twoor three cartridges. If bleeding occurred, this was controlled by the use of more gelfoam cartridges. RESULTS: Diagnostic target tissue was obtained in seven of the eight patients(87.5%). Hepatocellular carcinoma wasdiagnosed in five cases and metastatic cancer in two. Profuse bleeding was observed in one patient(12.5%) andresolved by gelfoam plugging. CONCLUSION: We believe that in patients with coagulopathy who are required toundergo liver biopsy plugging the liver biopsy track with gelfoam cartridge is a simple, safe and useful method.