Liver biopsy may carry risk for the patient. If the risk is too great, the procedure may have to be cancelled, at least under the current conditions. Sometimes one technique can be performed when another cannot be done.


Contraindications for percutaneous needle biopsy:

(1) bleeding disorder

(1a) bleeding time > 10 minutes;

(1b) prothrombin time > 3 seconds above the control despite receipt of intravenous vitamin K;

(1c) hemophilia if Factor 8 unavailable)

(1d) thrombocytopenia, with platelet count <= 50,000 per µL

(2) severe anemia

(3) peritonitis

(4) subphrenic effusion or abscess

(5) right pleural effusion or empyema

(6) marked ascites

(7) high grade biliary obstruction

(8) uncooperative or hypermobile patient despite sedation

(9) blood for transfusion unavailable

(10) possible hemangioma or vascular tumor

(11) inability to identify an appropriate site to biopsy by percussion or ultrasonography

(12) suspected echinococcal cysts in the liver

(13) morbid obesity


Contraindication to transjugular liver biopsy:

(1) serious cardiac arrhythmia triggered by catheter passage


Contraindications to laparoscopic liver biopsy:

(1) severe cardiopulmonary failure

(2) intestinal obstruction

(3) bacterial peritonitis

(4) large ventral hernia


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