We are aware of literature, based on retrospective data, suggesting that the Menghini needle is associated with fewer complications than the Tru-Cut needle; however, to our knowledge, randomized comparative trials of the two types of needles in an adequate number of patients have not been reported. We chose the cutting-type needle because many of our patients have relatively advanced fibrotic liver disease. Our general impression, and that of others, suggests that this type of needle has a better rate of retrieval of interpretable tissue than the aspiration-type needles.

Common sense dictates that the more experience an operator has the lower the complication rate. However, we looked at complication rate as a consequence of operator experience and found no relation at the Mayo Clinic, either when comparing more experienced staff with less experienced fellows or when comparing fellows observed during their early training as opposed to their late training. The fellows average approximately 80 to 100 liver biopsies during their training, roughly half in the type of patient described in our study and the other half in patients having had orthotopic liver transplantations.