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Short‐stay, out‐of‐hospital, radiologically guided liver biopsy
Author(s) -
Pokorny Christopher S,
Waterland Mark
Publication year - 2002
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2002.tb04286.x
Subject(s) - medicine , biopsy , radiology , liver biopsy , surgery , complication , ultrasound , radiological weapon , prospective cohort study
Objective: To evaluate the safety, the quality and adequacy of specimens obtained and the cost benefits associated with performing liver biopsy out of hospital, on a short‐stay basis, using radiological guidance. Design and setting: A prospective study undertaken over a three‐year period, from March 1998 to March 2001, in a private radiology practice. Patients and procedures: 251 patients (159 men) with stable liver disease participated. Coagulation studies were performed within a two‐week period before biopsy, which was carried out under the guidance of ultrasound (143 patients) or computed tomography (108 patients). A disposable, spring‐loaded gun with an 18‐gauge biopsy needle was used in each case. A repeat ultrasound or CT scan was performed after the procedure to monitor for complications such as haemorrhage. Main outcome measures: Complications of liver biopsy; adequacy of specimens for histological examination; cost of out‐of‐hospital procedures compared with liver biopsies performed in the hospital setting. Results: Two hundred and twenty nine patients (91.2%) were discharged 60 minutes after the biopsy. The only post‐biopsy complication was pain, either at the biopsy site or in the right shoulder. Pain was severe in three patients and, for one of these patients, a subcapsular hepatic haematoma was found on ultrasound eight days after the biopsy. Sufficient material for histopathological examination was obtained from all patients. The cost of out‐of‐hospital biopsies was substantially less than the cost of hospital‐based, day‐stay procedures. Conclusions: Short‐stay, out‐of‐hospital, radiologically guided liver biopsy is safe for patients who have stable chronic liver disease and acceptable coagulation profiles.