Do the needle type and the operator experience influence liver biopsy specimen quality?

Aim We evaluated the influence of the type of needle and the operator’s experience on the quality of the specimen obtained at liver biopsy (LB). Material and method We performed a multicentre, prospective study in four university hospitals, including LBs performed using either “cutting” (TruCut) or “suction” (Menghini) needles. According to their experience, we considered the operators as “junior” (<100 LBs) or “senior” (>100 LBs). Results A total number of 745 LBs were evaluated, 413 performed with suction needles and 332 with cutting needles. Of all LBs, 473 where performed by “senior” and 272 by “junior” operators. The mean length of the fragment obtained was larger in LBs performed by senior (23.5±11.6 mm) vs. junior operators (15.9±9.8 mm, p<0.001) and also if modified Menghini needles were used (23.7±12.1 mm) vs. TruCut (13.0±5.2 mm, p<0.001). The number of portal tracts (PT) was higher in LBs performed by “senior” (14.3±8.8 PT) vs. “junior” operators (8.8±6.8 PT, p<0.001); and with Menghini needles (17.2±9.7 PT) vs. TruCut (8.6±5.0 PT, p<0.001). Conclusion Our study demonstrates that optimal biopsy samples are obtained by two intrahepatic passages with Menghini needles and that “senior” operators obtain better tissue samples than “junior” ones.