Incidence of 0.03%-0.7% of intraperitoneal hemorrhage.
Significant hemorrhage occurs in .35-0.5% of procedures.
Associated with pain and/or major complications of bleeding, hemophilia, in as many as 20% and 0.5% of patients, respectively.
Subclinical hemorrhage occurs up to 23% of patients having ultrasound detected hematomas intrahepatically or subcapsularly.
Accepted mortality rate 0.1-.01 % from hemorrhage.
Hospitalization rate, mostly for management of post-biopsy pain is reported at 1.4-3.2%.
Size of the biopsy represents about 1/50,000th of the total liver mass.
An adequate length is a specimen of 1.5 cm and contains at least 6-8 portal triads.
Complication rate is less for physicians that have performed more than 50 biopsies per year.
Needles that require a longer time in the liver may increase the risk of bleeding.
When cirrhosis is suspected cutting needles are pref2242ed over suction needles since fibrotic tissues fragment with suction needles.
60% of complications occur within 2 hours of the procedure and 96% of those who experience complications do so by 24 hours.
1-3% of patients require hospitalization after liver biopsy secondary to pain or hypotension.
Arbitrary safety limits to perform the procedure is a 60% prothrombin activity and a platelet count of 60,000 per mm3.
Alternative methods of biopsy for patients at high risk of bleeding include transjugular biopsy, and plugged percutaneous biopsy.
Risk of hemorrhage increases with age, when more than 3 needle passes are made, and in the presence of cirrhosis or liver cancer.
Reproducibility of measuring liver iron is poor in diseased livers and is of limited use for serial measuremenets.