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Paediatric liver biopsies: A single-centre experience in Erzincan Binali Yıldırım University
Omer Kazci1, Ozlem Kadirhan2, Cigdem Uner3
1Department of Radiology, Faculty of Medicine, University of Higher Specialization, Ankara, Turkey.
Insights
Percutaneous liver biopsies in children are safe and effective for diagnosing liver conditions. This study found a low complication rate, supporting its use in pediatric care.
Area of Science:
- Pediatric Gastroenterology
- Interventional Radiology
- Diagnostic Imaging
Background:
- Liver biopsies are crucial for diagnosing pediatric liver diseases.
- Reported complication rates for pediatric liver biopsies vary.
- Percutaneous core liver biopsy under sonographic guidance is a key diagnostic tool.
Purpose of the Study:
- To review the complications, indications, and results of percutaneous core liver biopsies in pediatric patients.
- To evaluate the safety and efficacy of sonography-guided liver biopsies performed by interventional radiologists.
- To assess the outcomes in a tertiary care setting.
Main Methods:
- Retrospective evaluation of 58 percutaneous liver biopsies in 57 children (January 2017 - December 2020).
- Biopsies performed using 16G or 18G semi-automatic needles.
- Procedures conducted under local or general anesthesia based on patient age.
Main Results:
- The most common indications were elevated liver enzymes (33 patients) and cholestasis (14 patients).
- Chronic hepatitis (33 patients) and steatosis (10 patients) were the most frequent diagnoses.
- A single major complication (1.8%) of symptomatic subcapsular hematoma occurred with an 18G needle.
Conclusions:
- Sonography-guided percutaneous liver biopsies by interventional radiologists are safe and effective for pediatric patients.
- The procedure demonstrates a low complication rate, comparable to literature values.
- This method is a valuable tool for the diagnosis and management of pediatric liver pathologies.
Introduction:
Liver biopsies are the main method in the diagnosis and treatment of paediatric liver pathologies. Major complication rates of paediatric liver biopsies range from 0% to 6.6% in the literature and minor complication rates range from 0% to 25%. In this study, we aimed to review the complications, indications and results of percutaneous core liver biopsies with paediatric sonography in a tertiary care centre by an interventional radiologist.
Methods:
We retrospectively evaluated the results, indications and complications of paediatric liver biopsies performed in our tertiary health centre between January 2017 and December 2020. Biopsies were performed with a 16G semi-automatic needle in 17 patients (29.8%) and with an 18G semi-automatic needle in 40 patients (70.2%). Biopsies were performed only with local anaesthesia in patients older than 12 years; in younger patients, it was performed under general anaesthesia.
Results:
Fifty-eight liver biopsies were obtained from 57 children (34 males, 23 females). The most common indications were elevated liver enzymes (33 patients), cholestasis (14 patients), and adiposity and metabolic problems (6 patents). The most common pathological diagnoses were chronic hepatitis (33 patients) and steatosis (10 patients). Major complication in the form of symptomatic subcapsular haematoma developed after liver biopsy performed with 18G needle in only one patient (1.8%).
Conclusions:
As previously stated in the literature, percutaneous biopsies performed by interventional radiologists in paediatric patients under the guidance of sonography can be used in diagnosis and treatment; the complication rate is low and it is a safe method.
