Limited Post-observation Period in Pediatric Outpatient Ultrasound-Guided Liver Biopsies
Shireen Hayatghaibi1, Daniel Ashton2,3, Heather Cleveland2
1Texas Children's Hospital, 6701 Fannin St, Ste 470, Houston, TX, 77030-2608, USA. sehayatg@texaschildrens.org.
Purpose:
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.
Materials And Methods:
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].
Results:
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.
Conclusion:
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.
