Image-guided percutaneous hepatic biopsy: Effect of ascites on the complication rate

PURPOSE: To determine if image-guided percutaneous hepatic biopsy is contraindicated in patients with ascites. MATERIALS AND METHODS: The records of 476 patients (173 with ascites and 303 without) who underwent image-guided hepatic biopsy were reviewed retrospectively for number of passes, type of needle, and indications. Coagulopathy was corrected with appropriate blood products before biopsy. Complications were classified as minor (decrease in hematocrit value not necessitating treatment) or major (bleeding that necessitated transfusion or surgery or resulted in death). RESULTS: Major complications occurred in six patients with ascites and 10 without. Minor complications occurred in 10 patients with ascites and 15 without. With ascites, all major complications necessitated blood transfusions but not surgery. Five patients with major complications had a documented moderate or severe amount of perihepatic ascites. Without ascites, nine of the 10 patients required blood transfusions and one required surgery. No deaths occurred in either group. CONCLUSION: Perihepatic ascites does not statistically significantly affect the major or minor complication rate of image-guided percutaneous hepatic biopsy.