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November 1961

Complications of Needle Biopsy of the Liver: Perforation of the Gallbladder and Other Complications

Author Affiliations

From the Surgery Branch of the National Cancer Institute, National Institutes of Health, U.S. Public Health Service, U.S. Department of Health, Education and Welfare, Bethesda, Md.

Arch Surg. 1961;83(5):778-781. doi:10.1001/archsurg.1961.01300170134027

The well-established medical diagnostic and research aid of needle biopsy of the liver carries a very low mortality, but a somewhat higher major complication rate. In a comprehensive review of 20,016 cases, Zamcheck and Klausenstock7 found an over-all mortality rate of 0.194%. Others2, 5,6 have reported similar statistics. The chief causes of death have been hemorrhage and bile peritonitis, the hemorrhage being much more frequent. Bile peritonitis has occurred as a result of perforation of a distended bile radicle in obstructive jaundice or as a result of perforation of the gallbladder. The former can be avoided by refraining from the biopsy in the presence of extrahepatic obstructive jaundice.

We have been able to find only 5 cases of perforation of the gallbladder in the world literature. One of these resulted in bile peritonitis and was seen at laparotomy.6 Another was shown at autopsy,2 while a third