Abstract
To the Editor:— Dr. Robert Wilber and Dr. William Faulk's otherwise excellent review of liver biopsy ( 202 :53, 1967) is remiss, I believe, in not including reference to biopsy under direct vision at peritoneoscopy. Among its other advantages, peritoneoscopy allows one to aim the biopsy needle directly into a mass or other area of abnormality, thus increasing the likelihood of accurate diagnosis. Avoiding the liver edge lessens the chance of inadvertent penetration through the liver into colon or other viscus. If bleeding at the biopsy site does not cease in three to four minutes, direct pressure with the peritoneoscope or externally can be helpful, contributing further to safety. While not indicated in every patient requiring liver biopsy, peritoneoscopy can often enhance diagnostic accuracy and safety.
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