Statement on outpatient percutaneous liver biopsy

Abstract

This document represents a consensus statement dealing with optimum patient care in a significant clinical area. The statement has been prepared by the Patient Care Committee of the American Gastroenterological Association with the advice of other experts and with peer review. As with all such guidelines, this should be interpreted in a nondogmatic manner, so as not to exclude other therapies or opinions in any particular situation. Based on present knowledge, limited at times, future modifications or other changes in this statement may be necessary.

Outpatient Percutaneous Blind Needle Liver Biopsy: Safety and Cost Analysis

“…[6][7][8][9][10][11][12][13][14] This variability is probably related to differences in the definition of complications, the needle used, severity of the underlying illness, patient selection, and the experience of the physician performing the procedures.…”

“…[3][4][5] Several reports have, however, shown the safety of outpatient liver biopsy. [6][7][8][9][10][11][12][13][14] We wanted to report our experience of outpatient PBNLB, correlate the complications to Child's classification and co-existing renal failure, and compare the cost of outpatient PBNLB to inpatient PBNLB, for the following reasons: 1) Chronic liver diseases are common in Saudi Arabia; 2) most, if not all, hepatologists, gastroenterologists, and internists perform liver biopsies on an inpatient basis in Saudi Arabia; and 3) there are no published reports on a large series of outpatient liver biopsies in Saudi Arabia.…”

Complications of Liver Biopsy

“…As a result of the associated risks our patients are admitted for post biopsy observation for 6 hours as per the British society of Gastroenterology and the American Gastroenterological Association guidelines (Grant, et al 1999, Rockey, et al 2009). In other centres in the USA percutaneous liver biopsy is performed as an outpatient procedure with one of the stipulations being the patient is able to return to the hospital within 30 minutes if symptoms of a complication develop (Jacobs and Goldberg 1989).…”

Complications of Liver Biopsy

“…Delayed bleeding has been reported as late as 15 days after biopsy. (17) It has been reported in two large studies of patients post liver biopsy that bleeding occur in 0.32 -0.35% with morbidity related to hemorrhage of 0.24 % and around 0.11% had mortality from severe bleeding. (5,18) It has been found in some series that malignancy, cirrhosis, older age, and more than three passes were predictable risk factors for postbiopsy bleeding.…”