Clinical

Outpatient liver biopsy safe in selected patients

Last Updated: 2009-09-25 12:40:47 -0400 (Reuters Health)

By Will Boggs, MD

NEW YORK (Reuters Health) - Percutaneous liver biopsy can be performed safely in the outpatient setting, according to a report in the September European Journal of Internal Medicine.

Dr. Jose Presa from CHTMAD (Vila Real), Portugal, told Reuters Health by email that he and his colleagues perform "blind" liver biopsies (i.e., without ultrasound guidance) on outpatients "without any serious problems."

For the current paper, Dr. Presa and Dr. Elisabete Pinelo reviewed their experience with percutaneous liver biopsies done as ambulatory procedures in 192 patients between 2000 and 2007. Ultrasonography was done routinely 6 hours after the procedure, before discharge.

The vast majority of the patients (188, 97.9%) went home after the 8-hour surveillance period, the authors report, and the others required only brief admission to the hospital because of small, hemodynamically insignificant hemoperitoneum.

The most common minor complication was pain in the puncture site or right shoulder (in 22.4% of patients), and the only major complication was complete transitory atrioventricular block that resolved without hospital admission.

An appropriate sample was obtained in 92.4% of cases, the researchers note.

"A rigorous selection criteria and proper (patient) preparation are crucial aspects to the procedure success reducing substantially the number of serious complications," the authors explain.

"We exclude certain patients, like the patients with coagulation problems, low platelet count, (or) hepatic lesions," Dr. Presa added.

Also, according to the paper, to be eligible for outpatient liver biopsy a patient had to live less than 30 minutes away from the hospital and could not live alone.

Eur J Intern Med 2009;20:487-489.