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2017, Number 5

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Ann Hepatol 2017; 16 (5)

Clinical Characteristics and Complications of Pediatric Liver Biopsy: A Single Centre Experience

Almeida P, Schreiber RA, Liang J, Mujawar Q, Guttman OR

Language: English
References: 25
Page: 797-801
PDF size: 202.30 Kb.


ABSTRACT

Introduction. Percutaneous liver biopsy (LB) is the gold standard method for evaluation and management of patients with liver disease. The purpose of this study was to characterize pediatric patients undergoing LB at British Columbia Children's Hospital, and to determine the rate and timing of complications following the procedure. Material and methods. The medical records of all pediatric patients who underwent LB during a six-year retrospective study were reviewed to collect demographic and procedure-related data. Results. 223 LBs were performed, and 179 of these biopsies were percutaneous or transjugular. Elevated liver enzymes and cholestasis together accounted for almost 70% of the indications for LB, and the histological analysis of liver tissue yielded a specific diagnosis in 89 % of the cases. There were no deaths and no major complications related to LB. The most frequent minor complication was pain (59% of LBs) and the other complications were bleeding-related and classified as minor. The vast majority of complications (88%) were recognized within 8 h of the LB. Conclusions. LB is a valuable and safe procedure in pediatric patients with a low rate of complications. Pediatric patients can be discharged home safely should no complications occur within the first 8-12 h after the procedure.


REFERENCES

  1. Ovchinsky N, Moreira RK, Lefkowitch JH, Lavine JE. Liver biopsy in modern clinical practice: a pediatric point-of-view. Adv Anat Pathol 2012; 19: 250-62.

  2. Leeuwen DJ. Liver Biopsy. In Tytgat G, Mulder CJ (Eds). Procedures in Hepatogastroenterology. 1st ed. Springer Netherlands; 1997, p. 193-210.

  3. Terry R. Needle biopsy of the liver; with special reference to a modified Gillman technique. Br Med J 1949; 1: 657-60.

  4. Rustagi T, Newton E, Kar P. Percutaneous liver biopsy. Trop Gastroenterol 2010; 31: 199-212.

  5. Parets AD, Schaffner F, Black H. Percutaneous liver biopsy with the Menghini needle. Am J Dis 1959; 4: 693-9.

  6. Bruton OC, Metzger JF, Sprinz H. Experience with needle biopsy of the liver in infants and children. Pediatrics 1955; 16: 836-41.

  7. 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.

  8. Rockey DC, Caldwell SH, Goodman ZD, Nelson RC, Smith AD. Liver biopsy. Hepatology 2009; 49: 1017-44.

  9. Bravo AA, Sheth SG, Chopra S. Liver biopsy. N Engl J Med 2001; 344: 495-500.

  10. Dezsöfi A, Baumann U, Dhawan A, Durmaz O, Fischler B, Hadzic N, Hierro L, et al. Liver biopsy in children: Position paper of the ESPGHAN Hepatology Committee. J Pediatr Gastroenterol Nutr 2015; 60: 408-20.

  11. Sorbi D, McGill DB, Thistle JL, Therneau TM, Henry J, Lindor KD. An assessment of the role of liver biopsies in asymptomatic patients with chronic liver test abnormalities. Am J Gastroenterol 2000; 95: 3206-10.

  12. Skelly MM, James PD, Ryder SD. Findings on liver biopsy to investigate abnormal liver function tests in the absence of diagnostic serology. J Hepatol 2001; 35: 195-9.

  13. Pietrobattista A, Fruwirth R, Natali G, Monti L, Devito R, Nobili V. Is juvenile liver biopsy unsafe? Putting an end to a common misapprenhension. Pediatr Radiol 2009; 39: 959-61.

  14. Eisenberg E, Konopniki M, Veitsman E, Kramskay R, Gaitini D, Baruch Y. Prevalence and characteristics of pain induced by percutaneous liver biopsy. Anesth Anal 2003; 96: 1392-6.

  15. Short SS, Papillon S, Hunter CJ, Stanley P, Kerkar N, Wang L, Azen C, et al. Percutaneous liver biopsy: pathologic diagnosis and complications in children. J Pediatr Gastroenterol Nutr 2013; 57: 644-8.

  16. Govender P, Jonas MM, Alomari AI, Padua HM, Dillon BJ, Landrigan- Ossar MF, Chaudry G. Sonography-guided percutaneous liver biopsies in children. AJR Am J Roentgenol 2013; 201: 645-50.

  17. Azzam RK, Alonso EM, Emerick KM, Whitington PF. Safety of percutaneous liver biopsy in infants less than three months old. J Pediatr Gastroenterol Nutr 2005; 41: 639-43.

  18. Amaral JG, Schwartz J, Chait P, Temple M, John P, Smith C, Taylor G, et al. Sonographically guided percutaneous liver biopsy in infants: a retrospective review. AJR Am J Roentgenol 2006; 187: W644-9.

  19. Kalambokis G, Manousou P, Vibhakorn S, Marelli L, Cholongitas E, Senzolo M, Patch D, et al. Transjugular liver biopsy--indications, adequacy, quality of specimens, and complications--a systematic review. J Hepatol 2007; 47: 284-94.

  20. Caldwell SH. Management of coagulopathy in liver disease. Gastroenterol Hepatol (NY) 2014; 10: 330-2.

  21. Jacobs WH, Goldberg SB. Statement on out-patient percutaneous liver biopsy. Dig Dis Sci 1989; 34: 322-3.

  22. Firpi RJ, Soldevila-Pico C, Abdelmalek MF, Morelli G, Judah J, Nelson DR. Short recovery time after percutaneous liver biopsy: should we change our current practices? Clin Gastroenterol Hepatol 2005; 3: 926-9.

  23. Beddy P, Lyburn IL, Geoghegan T, Buckley O, Buckley AR, Torreggiani WC. Outpatient liver biopsy: a prospective evaluation of 500 cases. Gut 2007; 56: 307.

  24. Westheim BH, Østensen AB, Aagenæs I, Sanengen T, Almaas R. Evaluation of risk factors for bleeding after liver biopsy in children. J Pediatr Gastroenterol Nutr 2012; 55: 82-7.

  25. Matos H, Noruegas MJ, Gonçalves I, Sanches C. Effectiveness and safety of ultrasound-guided percutaneous liver biopsy in children. Pediatr Radiol 2012; 42: 1322-5.




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