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Same-Day versus Overnight Observation after Outpatient Pediatric Percutaneous Liver Biopsy: A Retrospective Cohort

Svetlana Yuryevna Kozlovich1, Anthony Alexander Sochet2, Sorany Son3

  • 1Department of Medicine, Pediatric Residency Program, Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA.

Pediatric Gastroenterology, Hepatology & Nutrition
|July 25, 2019
PubMed

Insights

Same-day observation after pediatric percutaneous liver biopsy (PLB) is safe and well-tolerated, with no major complications. This approach reduces healthcare costs compared to overnight stays for low-risk children.

Area of Science:

  • Pediatric Gastroenterology
  • Hepatology
  • Interventional Radiology

Background:

  • Percutaneous liver biopsy (PLB) is a key diagnostic tool for pediatric hepatobiliary disorders.
  • Current postoperative monitoring guidelines primarily focus on adults, leaving pediatric recovery time to operator discretion.
  • Standardizing post-biopsy observation protocols for children is crucial for patient safety and resource management.

Purpose of the Study:

  • To compare surgical complications, unplanned admissions, and healthcare costs for children undergoing outpatient PLB with same-day versus overnight observation.
  • To evaluate the safety and feasibility of same-day discharge after pediatric PLB.
  • To inform evidence-based guidelines for pediatric post-biopsy care.

Main Methods:

  • A retrospective cohort study of 112 children (1 month to 17 years) undergoing ultrasound-guided PLB.
  • Children were categorized into same-day (≤8 hours) or overnight observation cohorts.
  • Outcomes assessed included surgical complications, medical interventions, 7-day unscheduled hospitalizations, and total encounter costs.

Main Results:

  • No significant differences in demographics, comorbidities, or biopsy indications between cohorts.
  • No major complications or acute hospitalizations were observed in either group.
  • Same-day observation resulted in lower total healthcare costs (US $992 less per encounter) with only minor interventions (analgesia, fluid boluses) required within 8 hours.

Conclusions:

  • Same-day observation following pediatric PLB is a safe and well-tolerated recovery strategy for low-risk children.
  • Minor complications and interventions were observed within the 8-hour window, supporting same-day discharge feasibility.
  • A targeted risk assessment should guide the selection of observation duration after PLB in children.
Abstract

Keywords:
BiopsyComplicationsCost effectivenessLiverObservationSafety

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