Outpatient blind percutaneous liver biopsy in infants and children: is it safe?
- PMID: 22249089
- PMCID: PMC3271690
- DOI: 10.4103/1319-3767.91735
Outpatient blind percutaneous liver biopsy in infants and children: is it safe?
Abstract
Background/aim: We aim to investigate the safety of outpatient blind percutaneous liver biopsy (BPLB) in infants and children with chronic liver disease (CLD).
Patients and methods: BPLB was performed as an outpatient procedure using the aspiration Menghini technique in 80 infants and children, aged 2 months to 14 yrs, for diagnosis of their CLD. Patients were divided into three groups: Group 1 (<1 year), group 2 (1-6 yrs), and group 3 (6-14 yrs). The vital signs were closely monitored 1 hr before biopsy, and then 1, 2, 6, and 24 hrs after biopsy. Twenty-four hours pre- and post-biopsy complete blood counts, liver enzymes, prothrombin time (PT), and abdominal ultrasonography, searching for a biopsy-induced hematoma, were done for all patients.
Results: No mortality or major morbidities were encountered after BPLB. The rate of minor complications was 17.5% including irritability or "pain" requiring analgesia in 10%, mild fever in 5%, and drowsiness for >6 hrs due to oversedation in 2.5%. There was a statistically significant rise in the 1-hr post-biopsy mean heart and respiratory rates, but the rise was non-significant at 6 and 24 hrs except for group 2 where heart rate and respiratory rates significantly dropped at 24 hrs. No statistically significant difference was noted between the mean pre-biopsy and the 1, 6, and 24-hrs post-biopsy values of blood pressure in all groups. The 24-hrs post-biopsy mean hemoglobin and hematocrit showed a significant decrease, while the 24-hrs post-biopsy mean total leucocyte and platelet counts showed non-significant changes. The 24-hrs post-biopsy mean liver enzymes were non-significantly changed except the 24-hrs post-biopsy mean PT which was found to be significantly prolonged, for a yet unknown reason(s).
Conclusions: Outpatient BPLB performed by the Menghini technique is safe and well tolerated even in infants and young children. Frequent, close monitoring of patients is strongly recommended to achieve optimal patient safety and avoid potential complications.
Conflict of interest statement
Figures
Similar articles
-
Percutaneous liver biopsy in children: impact of ultrasonography and spring-loaded biopsy needles.J Pediatr Gastroenterol Nutr. 2000 Nov;31(5):536-9. doi: 10.1097/00005176-200011000-00015. J Pediatr Gastroenterol Nutr. 2000. PMID: 11144439
-
Safety and efficacy of blind percutaneous liver biopsy at the University College Hospital, Ibadan.Niger J Med. 2002 Oct-Dec;11(4):187-9. Niger J Med. 2002. PMID: 12955998
-
Prospective study of the incidence of ultrasound-detected hepatic hematomas 2 and 24 hours after percutaneous liver biopsy.Z Gastroenterol. 1990 May;28(5):247-50. Z Gastroenterol. 1990. PMID: 2205988
-
Complications after percutaneous liver biopsy in diffuse hepatopathies.Rom J Gastroenterol. 2005 Dec;14(4):379-84. Rom J Gastroenterol. 2005. PMID: 16400355 Review.
-
Transjugular liver biopsy: indications, technique and results.Diagn Interv Imaging. 2014 Jan;95(1):11-5. doi: 10.1016/j.diii.2013.08.009. Epub 2013 Sep 3. Diagn Interv Imaging. 2014. PMID: 24007769 Review.
Cited by
-
Incidence of Complications from Percutaneous Biopsy in Chronic Liver Disease: A Systematic Review and Meta-Analysis.Dig Dis Sci. 2022 Jul;67(7):3366-3394. doi: 10.1007/s10620-021-07089-w. Epub 2021 Jun 15. Dig Dis Sci. 2022. PMID: 34129125 Free PMC article.
-
"Safety and utility of percutaneous liver biopsy in hematopoietic stem cell transplant pediatric recipients: a retrospective study".BMC Cancer. 2016 Aug 2;16:590. doi: 10.1186/s12885-016-2603-8. BMC Cancer. 2016. PMID: 27485733 Free PMC article.
-
Evaluation of the diagnostic biopsy approach for children with hepatoblastoma: A report from the children's oncology group AHEP 0731 liver tumor committee.J Pediatr Surg. 2020 Apr;55(4):655-659. doi: 10.1016/j.jpedsurg.2019.05.004. Epub 2019 May 11. J Pediatr Surg. 2020. PMID: 31126688 Free PMC article.
References
-
- Bruton OC, Metzger JF Sprinz H. Experience with needle biopsy of the liver in infants and children. Pediatrics. 1955;16:836–41. - PubMed
-
- Kaye R, Koop CE, Wagner BM, Picou D, Yakovac WC. Needle biopsy of the liver, an aid in the differential diagnosis of prolonged jaundice in infancy. AMA J Dis Child. 1959;98:699–709. - PubMed
-
- Hong R, Schubert WK. Menghini needle biopsy of the liver. Am J Dis Child. 1960;100:42–6. - PubMed
-
- Porter M, Riley HD, Jr, Graham H. Needle biopsy of the liver in infants and children. J Pediatr. 1964;65:176–88. - PubMed
MeSH terms
LinkOut - more resources
Full Text Sources
Medical