关键词: 经皮肝穿刺活检, 病理诊断, 安全性, 适应证

Abstract: Objective To investigate the safety and application value of percutaneous liver biopsy. Methods A retrospective analysis was conducted on the clinical data of patients who underwent percutaneous liver biopsy in the Liver Cirrhosis Department of Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine from January 2014 to June 2023. The data included patient demographics (sex, age), blood routine tests, coagulation function, biochemical indicators of liver and kidney function, liver stiffness measurement,clinical diagnosis, and pathological diagnosis. The indications, complications and their management, and diagnostic value of percutaneous liver biopsy were analyzed and evaluated. Results Among the 727 patients who underwent percutaneous liver biopsy, aged between 19 and 86 years, liver biopsy was performed on the left lobe in 6 patients due to right liver atrophy (3 cases), excessive obesity (2 cases), and situs inversus (1 case), while the remaining patients underwent biopsy on the right lobe. 5 patients experienced post-biopsy hemorrhage complications (4 in the abdominal cavity and 1 in the pleural cavity), all of them with an INR less than 1.5 and platelet counts above 50×10⁹/L; no hemorrhage complications occurred in the 14 cases with platelet counts below 50×10⁹/L. In terms of diagnostic distribution, over 50% of the cases involved chronic hepatitis B, either with or without cirrhosis , primarily used in clinical trials to evaluate the efficacy of treatments for hepatitis B-related liver fibrosis. There were 200 patients (27.5%) who exhibited discrepancies between pre-biopsy clinical diagnosis and pathological diagnosis. Beyond differences in the assessment of cirrhosis severity, these discrepancies also included inconsistent etiological diagnoses, particularly in differentiating primary biliary cholangitis, autoimmune hepatitis, drug-induced liver injury, non-alcoholic steatohepatitis, and overlap syndromes. Conclusion Percutaneous liver biopsy is frequently used in diagnosing the etiology of unexplained liver injury and cirrhosis, differentiating autoimmune liver diseases, and assessing the severity of liver fibrosis and treatment efficacy. A platelet count below 50×10⁹/L is not the primary cause of post-biopsy complications such as hemorrhage, but caution should be exercised and a thorough assessment should be conducted before performing the biopsy.

Key words: Percutaneous liver biopsy, Pathological diagnosis, Safety, Indications