Early discharge after core liver biopsy: is it safe and cost-effective?

To determine if ambulatory patients who have undergone image-guided core liver biopsy with an 18-gauge needle and spring-loaded biopsy gun can be safely discharged after 1 hour of observation in the radiology department.

Fifty-four consecutive patients underwent ultrasound-guided core liver biopsy for a variety of suspected diffuse liver diseases. Post-biopsy, they were asked to grade their pain on a scale of 1-10 after 1 hour of recumbency on a hospital gurney in the department. At 2 weeks, all patients were contacted and asked about their level of pain and when they returned to normal activities.

Of the 54 patients enrolled, 4 were lost to follow-up. Pain was the most common minor complication, occurring in 31 (62%) of patients. The average level of pain after 1 hour was 2.1 (1 = no pain) and after 24 hours, 1.5. Seven patients were admitted to a medical daycare bed for a total of 4 hours and were then discharged. The remainder were discharged after 1 hour. Forty (80%) patients were pain-free after 24 hours, 36 (90%) of the 40 patients who were working returned to work the following day, and within a week, all patients had returned to all normal activities. No patients required an inpatient hospital stay or sought assistance at an emergency department.

These preliminary results demonstrate that ultrasound-guided 18-gauge liver core biopsy is a safe procedure, and, provided larger series confirm these findings, patients showing no complications can be discharged from the department after 1 hour with notable cost savings.