Needle Biopsy of the Liver

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NEEDLE puncture of the liver was first performed by Stanley1 in 1833 to drain an abscess, and was first employed as a diagnostic procedure by Lucatello2 in 1895. A few investigators in Europe have given accounts of diagnostic liver biopsies prior to 1939, but this technic did not come into widespread use until the report of Iversen and Roholm3 in 1939 on liver biopsy in 160 cases. With the advent of the war and increased incidence of hepatitis, general use gradually was made of liver biopsy as a diagnostic technic. Needle biopsy was utilized during the war chiefly as a means of studying the pathology of infectious hepatitis. Since then it has proved valuable in other conditions as well.

The first method of liver biopsy consisted of simple aspiration of a few liver cells with a smear made of the material obtained. Iversen and Roholm used a similar aspiration technic, but removed a plug of tissue which proved to be more satisfactory. A number of investigators have taken a specimen for biopsy at operation 4, 5 or have used small incisions to obtain one. Biopsy specimens also have been obtained during peritoneoscopic examination.6 A refinement of the early technic has been the “Vim” Silverman needle used to secure a plug of tissue satisfactory for pathologic study.

Investigators have used the intercostal approach, the subxyphoid, and the subcostal. Many have been concerned over possible tears in the liver capsule that might be caused by respiratory movement with the intercostal approach.



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