Limited Post-observation Period in Pediatric Outpatient Ultrasound-Guided Liver Biopsies

• DOI: 10.1007/s00270-017-1720-3
• Publication Date: 2017-06-08T12:02:51Z
• Authors: Shireen Hayatghaibi; Daniel Ashton; Heather Cleveland; Kamlesh Kukreja
• Keywords: Image-Guided Biopsy; Male; Time Factors; Adolescent; Biopsy, Needle; Infant, Newborn; Infant; 3. Good health; Cohort Studies; 03 medical and health sciences; 0302 clinical medicine; Liver; Child, Preschool; Outpatients; Humans; Female; Child; Ultrasonography, Interventional; Monitoring, Physiologic; Retrospective Studies

We retrospectively studied whether a limited 2 h post-biopsy observation period after a percutaneous outpatient ultrasound-guided liver biopsy is a sufficient monitoring period for children.This study is an IRB-approved retrospective cohort review of consecutive outpatient percutaneous ultrasound-guided liver biopsies from June 01, 2014, to June 30, 2016. A total of 198 biopsies in 192 patients (85 females and 113 males) underwent an outpatient ultrasound-guided liver biopsy between June 01, 2014, and June 30, 2016 (age range 3 weeks-18 years, mean 11.6 years). Outpatient biopsies were performed with a limited patient observation time [median (IQR) observation 2.25 (0.83) h].Adequate histopathology was obtained in 99% (197/198) of cases. Only one case was determined by a pathologist as not sufficient to render a diagnosis. 84% (166/198) of the biopsies were performed with a 16G needle, and 16% (32/198) were performed with an 18G needle. Overall, seven complications were detected (3.5% of all biopsies, 7/198) in seven patients. All complications detected were minor, 1.5% (3/198) were categorized as SIR A and 2% (4/198) as SIR B. The most common complication included pain after biopsy (4/198), followed by rash at the biopsy site (3/198). No major complications were detected in our sample.In a consecutive cohort of children, the use of a limited 2 h observation period after an ultrasound-guided percutaneous biopsy was a sufficient monitoring period for complications. Additionally, we did not observe a high proportion of patients returning for follow-up medical care after discharge due to complications.