VALUE OF TRANS-ABDOMINAL ULTRASOUND-GUIDED PERCUTANEOUS LIVER BIOPSY IN PATIENTS WITH FOCAL OR DIFFUSE LIVER LESIONS IN KURDISTAN CENTRE FOR GASTROENTEROLOGY AND HEPATOLOGY IN SULAIMANI CITY

Dana Taib Gharib a, Mohammed Omer Mohammed b, Taha Ahmad Al-Karboly b, Heero Ismael Faraj c, Kawa Abdullah Mahmood b, Nasr Abdulla Qazi b, Karok Hassan Salih b, and Omar Hama Ghalib Azeez d


KBMS trainee in Gastroenterology and Hepatology, KCGH, Sulaimani, Iraq.
b College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.
c Kurdistan Center of Gastroenterologist, KCGH, Kurdistan Region, Iraq. 
d KBMS Trainee in GI surgery, KCGH, Sulaimani, Kurdistan Region, Iraq.

Submitted: 15/7/2019; Accepted: 27/7/2020; Published: 21/9/2020

ABSTRACT


Background 

Percutaneous Liver Biopsy (PLB) is commonly used for assessing the histopathological status of the liver and thus deciding on diagnosis, prognosis, and management plan of patients. 


Objectives

To assess the value of Percutaneous Liver Biopsy in decision making in patients referred to Kurdistan Centre for Gastroenterology and Hepatology (KCGH), and searching the common causes of liver enzyme abnormalities especially in patients with the unknown clue of diagnosis.


Patients and Methods

This study was performed in Kurdistan Center for Gastroenterology and Hepatology, between April 2018 and January 2019; Sixty-three patients have been included in this study, which was referred for PLB with different intentions; after appropriate pre-procedural preparation PLB was performed with the aid of a radiologist, and post-procedural follow up of patients was done for 6 hours in the ward. 


Results

The reason of referral for PLB was diagnostic, prognostic, and management in 79.8%, 14.3%, and 6.3% respectively. Common diagnoses in a diffuse parenchymal liver lesion with or without elevated liver enzymes were AIH in 15.8%, DILI in 14.3%, and NASH 14.2%. Percutaneous liver biopsy changed the preliminary diagnosis in 52.3%, and management plan in 34.9% of cases. As PLB is an invasive procedure, 31.7% of patients developed complications, which is in decreasing order including right upper quadrant pain 15.9%, right shoulder pain 5.9%, combined right upper quadrant pain, and right shoulder pain in 3.2%, and vasovagal reaction in 3.2 %.


Conclusion

Percutaneous liver biopsy is a valuable investigation in deciding on diagnosis, the prognosis of liver lesions, and it will help the management plan. The three most common diseases which should be excluded in every patient with diffuse parenchymal liver lesions or elevated liver enzymes are AIH, DILI, and NASH.

Keywords: Percutaneous Liver Biopsy; KCGH; Autoimmune Hepatitis; Kurdistan, Iraq.



KEYWORDS

Percutaneous Liver Biopsy; KCGH; Autoimmune Hepatitis; Kurdistan, Iraq.