https://aasldpubs.onlinelibrary.wiley.com/doi/epdf/10.1053/jhep.2000.16602

Practices of Liver Biopsy in France: Results of a Prospective Nationwide Survey

Lipid--an emerging platform for oral delivery of drugs with poor bioavailability.

A consensus document on bowel preparation before colonoscopy: Prepared by a Task Force From The American Society of Colon and Rectal Surgeons (ASCRS), the American Society for Gastrointestinal Endoscopy (ASGE), and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES)

OBJECTIVE. The purpose of this study was to evaluate our preliminary experience using diffusion-weighted MRI for quantification of liver fibrosis.SUBJECTS AND METHODS. Diffusion-weighted MRI with single-shot echo-planar technique at b values of 50, 300, 500, 700, and 1,000 s/mm2 was prospectively performed on 23 patients with chronic hepatitis and on seven healthy volunteers. The apparent diffusion coefficient (ADC) was measured in four locations in the liver. Liver biopsy results (n = 19) were retrospectively reviewed by two hepatopathologists in consensus to determine stage of fibrosis and grade of inflammation. A Mann-Whitney test was used to compare the ADCs between patients classified with respect to having stage 2 or greater versus stage 1 or less fibrosis and stage 3 or greater versus stage or less 2 fibrosis. Receiver operating characteristics analysis was used to assess the performance of ADC in prediction of the presence of stage 2 or greater and stage 3 or greater fibrosis.RESULTS. Using a b va...

https://www.ajronline.org/doi/pdf/10.2214/AJR.07.2086

Diffusion-Weighted MRI for Quantification of Liver Fibrosis: Preliminary Experience

AIM: To study the complications and the risk factors of percutaneous liver biopsy, and to compare the complication rate between the periods o f 1987-1993 and 1994-1996.

METHODS: Medical records of all patients undergoing percutaneous liver biopsy between January 1, 1987 to September 31, 1996 in Songklanagarind Hospital were reviewed retrospectively.

RESULTS: There were 484 percutaneous liver biopsies performed. The total complication rate was 6.4%, of which 4.5% were due to major bleeding; the death rate was 1.6%. The important risk factors correlated with bleeding complications and deaths were a platelet count of 70 × 109/L or less, a prolonged prothrombin time of > 3 s over control, or a prolonged activated partial thromboplastin time of > 10 s over control. Although physician inexperience was not statistically significantly associated with bleeding complications and deaths, there was a reduction of death rate from 2.2% in 1987-1993 to 0% in 1993-1996. This reduction is thought to result from both increased experience o f senior staff and increased supervision of residents.

CONCLUSIONS: Screening of platelet count, prothrombin time, and activated partial thromboplastin time should be done and need to be corrected in case of abnormality before liver biopsy. Percutaneous liver biopsy should be performed or supervised by an expert in gastrointestinal diseases, especially in high risk cases.

pdf/liver-biopsy-complications-and-risk-factors-24o3zi6jgh.pdf

Liver biopsy:complications and risk factors.

Studies on the complication rate of liver biopsy have hitherto been conducted in referral hospital centers. They are therefore not representative for general practice where liver biopsy is performed by specialists and nonspecialists. In a postal nationwide survey, we approached all gastroenterologists and hospital internists to assess the complication rate and practice (setting, needle type, use of ultrasonography) of percutaneous liver biopsy performed in 1989 in Switzerland for diffuse liver disease. Two hundred eighty questionnaires were mailed and 252 were returned (response rate 90.0%) 165 respondents (65.5%) performed 3501 biopsies while 87 respondents (34.5%) did not practice liver biopsy; 67.7% of biopsies were executed blindly and 32.3% were guided. Eight nonfatal and three fatal complications occurred. Hemorrhage was the most frequent complication (five cases) and was responsible for all three fatal outcomes. The overall complication rate was 0.31%, being distinctly lower in the group of gastroenterologists (0.11%) as compared to the group of internists (0.55%;P=0.031). The complication rate was 1.68% in the group of internists performing fewer than 12 biopsies per year, while there was no complication in the group of internists performing more than 50 biopsies per year (P=0.036). Complications were not related to the needle diameter or to the absence of ultrasonography before biopsy. In conclusion, this representative survey in Switzerland shows that the complication rate of liver biopsy is mainly related to the experience and training of the operator.

Practice and complications of liver biopsy. Results of a nationwide survey in Switzerland.

Postprandial gallbladder contraction is mainly regulated by cholecystokinin (CCK), but little is known about the dose-response relationship between CCK release and gallbladder contraction, in particular after meals with differing fat content. Decreased postprandial gallbladder emptying has been suggested to play a major role in the development of gallstones in man, and dietary factors may therefore be important in the pathogenesis of gallbladder stasis. We studied, in a randomized order, the effect of three isocaloric meals (250 ml) with identical osmolality on CCK release and gallbladder contraction in six healthy volunteers: (1) a pure fat meal (25 g triglycerides); (2) a mixed meal containing fat (8 g, 29% of caloric content), protein (10 g, 17%), and dextrose (32 g, 54%); and (3) a fat-free meal containing albumin (25 g, 46%) and dextrose (32 g, 54%). Gallbladder volumes and antral cross-sectional areas were determined by ultrasonography and plasma CCK and PP levels by RIA. The pure fat meal caused the highest CCK release (187 +/- 27; mean +/- SEM) and maximal (> 85% of fasting volume) gallbladder contraction (3172 +/- 361; AUC) as compared to the other two meals (P < 0.05). The mixed and the fat-free meal caused similarly low (< 50% of fasting volume) gallbladder contraction (6052 +/- 342 and 6134 +/- 500, respectively), although they induced markedly different CCK levels (157 +/- 12 and 87 +/- 13, respectively; P < 0.05). Gastric emptying rates were similar for all meals (18,500 +/- 3300, 18,600 +/- 2700 and 19,800 +/- 3100, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Role of nutrient fat and cholecystokinin in regulation of gallbladder emptying in man.

https://www.giejournal.org/article/S0016-5107(92)70521-5/pdf

Low sodium solution for colonic cleansing: a double-blind, controlled, randomized prospective study.

https://www.giejournal.org/article/S0016-5107(91)70724-4/pdf

Palatability of a new solution compared with standard polyethylene glycol solution for gastrointestinal lavage

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Papers

Practice and complications of liver biopsy. Results of a nationwide survey in Switzerland.

Role of nutrient fat and cholecystokinin in regulation of gallbladder emptying in man.

Low sodium solution for colonic cleansing: a double-blind, controlled, randomized prospective study.

Palatability of a new solution compared with standard polyethylene glycol solution for gastrointestinal lavage