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Safety of pediatric percutaneous liver biopsy performed by interventional radiologists
Carol Potter1, Mark J Hogan, Katherine Henry-Kendjorsky
1Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Nationwide Children's Hospital and Ohio State University, Columbus, OH, USA. carol.potter@nationwidechildrens.org
Insights
Pediatric interventional radiologists perform liver biopsies safely and effectively. This study shows ultrasound-guided percutaneous liver biopsy in children by interventional radiologists has low complication rates, comparable to pediatric gastroenterologists.
Area of Science:
- Pediatric radiology
- Gastroenterology
- Interventional radiology
Background:
- Pediatric percutaneous liver biopsy is increasingly performed by interventional radiologists.
- Data comparing interventional radiologists and pediatric gastroenterologists are limited.
Purpose of the Study:
- To describe the safety and effectiveness of percutaneous liver biopsy performed by interventional radiologists in children.
- To compare these outcomes with existing literature on biopsies performed by pediatric gastroenterologists.
Main Methods:
- Retrospective review of 294 ultrasound-guided percutaneous liver biopsies performed by interventional radiologists in 249 children.
- Adverse events and tissue acquisition success were assessed.
Main Results:
- No deaths occurred. Complications included minor hemoglobin drops (2), one asymptomatic pneumothorax, and one case of sepsis.
- Adequate tissue samples were obtained in all but one case.
- The complication rate was favorable compared to published data for pediatric gastroenterologists.
Conclusions:
- Ultrasound-guided percutaneous liver biopsy by experienced pediatric interventional radiologists is safe and effective.
- Outcomes are comparable to those achieved by pediatric gastroenterologists.
Objective:
National data suggest that pediatric percutaneous liver biopsy is increasingly being performed by interventional radiologists rather than pediatric gastroenterologists. The objective of the present report is to describe the safety and effectiveness of percutaneous liver biopsy performed by interventional radiologists in a large cohort of children and to compare the results with the existing literature on biopsies performed by pediatric gastroenterologists.
Patients And Methods:
The medical records of 249 children undergoing ultrasound-guided percutaneous liver biopsy by interventional radiologists were reviewed for adverse events and success of obtaining tissue. Two hundred ninety-four biopsies were reviewed.
Results:
There were no deaths. There were 2 instances of a 2-g or greater drop in hemoglobin following biopsy, neither of which was associated with clinical signs of hemorrhage. A small, asymptomatic pneumothorax quickly resolved without treatment. One patient developed Klebsiella sepsis 48 hours after biopsy. In all but 1 case, an adequate sample size was obtained. This low incidence of adverse events compares favorably with existing published reports of morbidity and mortality following percutaneous liver biopsy performed by pediatric gastroenterologists.
Conclusions:
Ultrasound-guided percutaneous liver biopsy performed by experienced pediatric interventional radiologists in a children's hospital setting is as safe and effective as biopsy performed by pediatric gastroenterologists.
