A Comparison of Needle Types and Biopsy Techniques Used in Liver Biopsies of Chronic Hepatitis B Patients

Objectives: To investigate the effect of the biopsy technique used in percutaneous liver biopsies applied with semi-automatic 16 gauge (G) and 18G Tru-cut and Menghini aspiration needles in patients with chronic hepatitis B (CHB) on pathological evaluation. Materials and Methods: The study included 104 cases diagnosed with CHB who underwent liver biopsy between 2013 and 2018. The pathology results of biopsies were evaluated with the Menghini technique under ultrasound (USG) guidance (n=26), and with 16G (n=54) and 18G (n=24) semi-automatic Tru-cut needles under USG. Results: The fibrosis score in 5 (9.3%) of the 16G cases and in 3 (12.5%) of the 18G cases, and the ISHAK score in 3 (5.6%) of the 16G and in 1 (4.2%) of the 18G cases could not be determined. There was no significant difference between the methods and needle types in terms of the number of pieces, number of portal sites, fibrosis and ISHAK score (p>0.05). There was a statistically significant difference between the biopsies performed with Menghini method and Tru-cut method with 16G and 18G (p<0.0001) in terms of material length. The diagnosis rates for the Menghini technique, and 16G and 18G Tru-cut needles were 100%, 90.7% and 83.3%, respectively, with no statistically significant difference determined (p>0.05). Conclusion: Although a larger tissue piece is obtained with the Menghini technique, allowing evaluation of a larger portal area, no significant difference was determined between the techniques in the pathological evaluation. Taking patient safety and comfort into consideration, Tru-cut needle biopsy under USG guidance is recommended rather than the Menghini technique as less trauma is created.