How to perform a surgical hepatic biopsy - Veterinary Medicine
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How to perform a surgical hepatic biopsy
An open surgical method greatly improves your chances of obtaining a diagnostic liver biopsy sample. The specific biopsy technique you should use depends on the site from which you are sampling.


VETERINARY MEDICINE


COMPLICATIONS

Complications after liver biopsy are uncommon but may include bile peritonitis, hemorrhage, and sepsis. The risk of complications is greater in patients with coagulopathies and thrombocytopenia.14,15 Major complication rates during hepatic biopsies have been reported to be as high as 22% and 50% in dogs and cats that are thrombocytopenic.14 Many patients with liver disease are debilitated from hypoalbuminemia and compromised liver function, increasing the risk of potential complications with anesthesia and surgery such as hypotension and altered metabolism of anesthetic and analgesic drugs.

Diana Burger, BS
Amie Carrier, BS
Karen M. Tobias, DVM, MS, DACVS
Department of Small Animal Clinical Sciences
College of Veterinary Medicine
The University of Tennessee
Knoxville, TN 37996-4544

REFERENCES

1. Day DG. Indications and techniques for liver biopsy. In: Textbook of veterinary internal medicine. 5th ed. Philadelphia, Pa: WB Saunders Co, 2000;1294-1298.

2. Martin RA, Lanz OI, Tobias KM. Liver and biliary system. In: Small animal surgery. 3rd ed. Philadelphia, Pa: WB Saunders Co, 2003;713-717.

3. Fossum TW. Surgery of the liver. In: Small animal surgery. 2nd ed. St. Louis, Mo: Mosby, 2002;450-457.

4. Harvey CE, Newton CD, Schwartz A. The liver and biliary tract, spleen, and pancreas. In: Small animal surgery. Philadelphia, Pa: JB Lippincott Co, 1990;407-411.

5. Wang KY, Panciera DL, Al-Rukibat RK, et al. Accuracy of ultrasound-guided fine-needle aspiration of the liver and cytologic findings in dogs and cats: 97 cases (1990-2000). J Am Vet Med Assoc 2004;224:75-78.

6. Cohen M, Bohling MW, Wright JC, et al. Evaluation of sensitivity and specificity of cytologic examination: 269 cases (1999-2000). J Am Vet Med Assoc 2003;222:964-967.

7. de Rycke LMJH, van Bree HJJ, Simoens PJM. Ultrasound-guided tissue-core biopsy of liver, spleen and kidney in normal dogs. Vet Radiol Ultrasound 1999;40:294-299.

8. Cole TL, Center SA, Flood SN, et al. Diagnostic comparison of needle and wedge biopsy specimens of the liver in dogs and cats. J Am Vet Med Assoc 2002;220:1483-1490.

9. Valverde A, Doherty TJ, Hernandez J, et al. Effect of lidocaine on the minimum alveolar concentration of isoflurane in dogs. Vet Anaesth Analg 2004;31:264-271.

10. Hellyer PW, Mama KR, Shafford HL, et al. Effects of diazepam and flumazenil on minimum alveolar concentrations for dogs anesthetized with isoflurane or a combination of isoflurane and fentanyl. Am J Vet Res 2001;62:555-560.

11. Garner MM, Raymond JT, Toshkov I, et al. Hepatocellular carcinoma in black-tailed prairie dogs (Cynomys ludivicianus): tumor morphology and immunohistochemistry for hepadnavirus core and surface antigens. Vet Pathol 2004;41:353-361.

12. Richter KP. Laparoscopy in dogs and cats. Vet Clin North Am Small Anim Pract 2001;31:707-727.

13. Kim EH, Kopecky KK, Cummings OW, et al. Electrocautery of the tract after needle biopsy of the liver to reduce blood loss. Invest Radiol 1993;28:228-230.


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