Table 1s. Descriptive statistics of the population
Significant diseases known before diagnosis (more than one could apply)
Chronic liver disease 596/800 74.5%
Cirrhosis 215/800 26.9%
Chronic heart disease 305/800 38.1%
Chronic kidney disease 38/800 4.8%
Malignant neoplasia 419/800 52.4%
Relevant medications (more than one could apply)
Acetylsalicylic acid 67/800 8.4%
Nonsteroidal ani-inflammatory drugs 6/800 0.8%
Direct antiplatelet agents 9/800 1.1%
Low molecular weight heparin 80/800 10%
Unfractioned heparin 5/800 0.6%
Warfarin 11/800 1.4%
Direct oral anticoagulants 8/800 1%
Steroids 58/800 7.3%
Immunosuppressors 35/800 4.4%
Antitumoral therapy 14/800 1.8%
Ascites
Absent 770/800 96.3%
Grade I 0/800 .
Grade II 27/800 3.4%
Grade III 3/800 0.4%
Portosystemic encephalopathy
No 797/800 99.6%
Yes (grade II) 3/800 0.4%
Target of liver biopsy
Diffuse liver disease 275/800 34.4%
Focal lesion 525/800 65.6%
Procedures performed before liver biopsy
Platelet transfusion 3/800 0.4%
Paracenthesis 3/800 0.4%
Mild sedation (benzodiazepines) 2/800 0.3%
Laboratory results
Median Range N
Platelet count (n/µL) 217000 7000-787000 636
INR 1.1 0.82-2.87 597
Creatinine (mg/dL) 0.85 0.34-12.6 309
Total bilirubin (mg/dL) 0.93 0.2-33.9 386
Albumin (g/dL) 3.6 1.3-5.9 212
GOT (U/L) 47 2-2445 399
GPT (U/L) 46.5 3-1712 402
Table 2s. Count of liver biopsies performed by each center and operator during the study period.
Number of procedures (study period, n = 800)
% Procedures performed before the study period
Center A (2008-2018) 486 60.8%
Operator 1 339 42.4% ≥ 50
Operator 2 49 6.1% < 50
Operator 3 23 2.9% ≥ 50
Operator 4 70 8.8% < 50
Operator 5 5 0.6% ≥ 50
Center B (2016-2018) 314 39.3%
Operator 6 230 28.8% ≥ 50
Operator 7 84 10.5% < 50
Table 3s. Details of needle types and diameters
Ratio Percentage
Needle Type
Semiautomatic suction (alone, 1 or ≥2 insertions) 788/800 98.4%
Cutting 2/800 0.3%
Chiba 3/800 0.4%
Spinal 2/800 0.3%
Suction + Cutting (≥ 2 insertions) 5/800 0.6%
Needle caliber
Semiautomatic suction
16G 38/800 4.8%
17G 16/800 2%
18G 503/800 62.8%
19G 198/800 24.8%
20G 5/800 0.6%
21G 28/800 3.5%
Cutting
18G 7/800 0.9%
Chiba
18G 1/800 0.1%
19G 2/800 0.3%
Spinal
18G 1/800 0.1%
22G 1/800 0.1%
Number of insertions*
1 688/800 86%
2 107/800 13.4%
3 4/800 0.5%
4 1/800 0.1%
* When single insertion was performed, suction needle was used in 685 cases, cutting needle in 2 cases, spinal needle in 1 case. When 2 insertions were performed, operators used suction needle twice in 101 cases, Chiba needle twice in 2 cases and spinal needle twice in 1 case; in 3 cases a first insertion with suction needle was followed by insertion of a cutting needle. When 3 insertions were made, in 1 case only a suction needle was used, in 1 case only a Chiba needle was used and in 1 case a double insertion with suction needle was followed by cutting needle insertion. In a single case 4 insertions were made: the first three with suction needles and the last one with a cutting needle.
