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Ultrasound-guided Liver Biopsies in Children: A Single-center Experience and Risk Factors for Minor Bleeding
Carlos Bilreiro1, Maria J Noruegas, Isabel Gonçalves
1*Serviço de Imagem Médica, Polo Hospital Pediátrico †Unidade de Transplantação Hepática, Hospital Pediátrico de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
Journal of Pediatric Gastroenterology and Nutrition
|April 11, 2017
Summary
Pediatric ultrasound-guided liver biopsies are safe and effective. More needle passes increase minor bleeding risk, while transplanted livers show reduced bleeding complications.
Area of Science:
- Pediatric Gastroenterology
- Interventional Radiology
- Hepatology
Background:
- Ultrasound-guided liver biopsy is a crucial diagnostic tool in pediatric patients.
- Previous studies from our institution highlighted the need for further analysis of complication risk factors.
Purpose of the Study:
- To evaluate the safety and efficacy of ultrasound-guided liver biopsies in children.
- To identify specific risk factors associated with complications in pediatric liver biopsies.
Main Methods:
- Retrospective analysis of 228 consecutive ultrasound-guided liver biopsies in children (2011-2016).
- Data collected included patient demographics, biopsy indications, coagulation parameters (INR, platelet count), technique, and outcomes.
- Statistical analysis was performed to identify predictors of complications.
Main Results:
- 228 biopsies were performed on 203 children (median age 9.25 years).
- 27 cases (11.84%) experienced immediate minor bleeding; no major complications occurred.
- Increased needle passes predicted bleeding (P=.0023), while transplanted livers showed a protective effect (P=.0007).
Conclusions:
- Ultrasound-guided liver biopsy is a safe procedure in pediatric patients with a high diagnostic yield.
- The number of needle passes is a significant predictor of minor bleeding.
- Factors like younger age, lower body weight, and altered coagulation parameters are associated with bleeding risk, though not predictive; transplanted livers have a lower risk.