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The Safety of Same-Day Endoscopy and Percutaneous Liver Biopsy

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Abstract

Background and Aims

The aim of this study was to review our experience with same-day endoscopy (SDE) plus percutaneous liver biopsy (PLB) and to evaluate its safety compared to PLB alone.

Methods

We retrospectively examined records of all patients who underwent PLB between January 2003 and September 2009 and identified those who underwent SDE and matched these patients to those undergoing PLB alone. Serious adverse events (SAEs) were analyzed using our endoscopic database (EndoPro, Pentax) and were divided into those occurring immediately post-procedure and those occurring after discharge.

Results

In the study, 479 patients underwent 507 PLBs and 52 patients (11%) were identified as having SDE. No statistical differences were apparent in terms of sex, age, baseline laboratory values, medical comorbidities, cirrhosis, or liver lesions. The most common indication for PLB was chronic hepatitis C (HCV). A total of 15 patients underwent upper endoscopy (EGD); 37 patients underwent colonoscopy (most for colorectal cancer screening). One (1.9%) SAE occurred in the SDE and PLB group. This patient experienced microperforation of the hepatic flexure secondary to abnormal anatomy and underwent immediate laparoscopic repair with an unremarkable post-op course. Four (0.88%) SAEs occurred with PLB alone, mostly prolonged pain from subcapsular hematoma, with no transfusions or surgery required.

Conclusions

At our institution, SDE with PLB is often performed and appears to be a safe method of practice. We believe that performance of EGD or colonoscopy on the same day as PLB optimizes medical resources and results in patient satisfaction without sacrificing safety.

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References

  1. Cook JA, Harrison SA. Same day endoscopy and percutaneous liver biopsy: safety and cost-effectiveness. Dig Dis Sci. 2009;54:1753–1757.

    Article  PubMed  Google Scholar 

  2. Bravo AB, Sheth SG, Chopra S. Liver Biopsy. N Engl J Med. 2001;344(7):495–500.

    Article  PubMed  CAS  Google Scholar 

  3. Froehlich F, Lamy O, Fried M, Gonvers JJ. Practice and complications of liver biopsy: results of a nationwide survey in Switzerland. Dig Dis Sci. 1993;38:1480–1484.

    Article  PubMed  CAS  Google Scholar 

  4. Grant A, Neuberger J. Guidelines on the use of liver biopsy in clinical practice. Gut. 1999;45(Suppl IV):1–11.

    Google Scholar 

  5. Padia SA, et al. Safety and efficacy of sonographic-guided random real time core needle biopsy of the liver. J Clin Ultrasound. 2009;37(3):138–143.

    Article  PubMed  Google Scholar 

  6. Younossi ZM, et al. Ultrasound-guided liver biopsy for parenchymal liver disease: an economic analysis. Dig Dis Sci. 1998;43(1):46–50.

    Article  PubMed  CAS  Google Scholar 

  7. Lindor KD, et al. The role of ultrasonography and automatic-needle biopsy in outpatient percutaneous liver biopsy. Hepatology. 1996;23(5):1079–1083.

    Article  PubMed  CAS  Google Scholar 

  8. Pasha T, et al. Cost-effectiveness of ultrasound-guided liver biopsy. Hepatology. 1998;27(5):1220–1226.

    Article  PubMed  CAS  Google Scholar 

  9. Riley TR. How often does ultrasound marking change liver biopsy site? Am J Gastroenterol. 1999;94(11):3320–3322.

    Article  PubMed  Google Scholar 

  10. Mayoral W, Lewis JH. Percutaneous liver biopsy: what is the current approach? Results of a questionnaire survey. Dig Dis Sci. 2001;46(1):118–127.

    Article  PubMed  CAS  Google Scholar 

  11. Muir AJ, Trotter JF. A survey of current liver biopsy practice patterns. J Clin Gastroenterol. 2002;35(1):86–88.

    Article  PubMed  Google Scholar 

  12. Copel L, et al. Ultrasound-guided percutaneous liver biopsy: indications, risks and technique. Surg Technol Int. 2003;11:154–160.

    PubMed  Google Scholar 

  13. Rossi P, et al. Percutaneous liver biopsy using an ultrasound-guided subcostal route. Dig Dis Sci. 2001;46(1):132–136.

    Article  Google Scholar 

  14. Al Knawy B, Shiffman M. Percutaneous liver biopsy in clinical practice. Liver Int. 2007;27(9):1166–1173.

    Article  PubMed  Google Scholar 

  15. Rockey DC, et al. AASLD position paper: liver biopsy. Hepatology. 2009;49(3):1017–1044.

    Article  PubMed  Google Scholar 

  16. Lee RG. Diagnostic liver pathology. Mosby-Year Book: St. Louis. 1994. 1–21.

  17. Klatskin G, Conn HO. Histopathology of the liver. Oxford University Press: New York. 1993(1):3–8.

  18. Garcia-Tsao G, Boyer JL. Outpatient liver biopsy: how safe is it? Ann Intern Med 1993(118):150–3.

  19. Jacobs WH, Goldberg SB. Patient Care Committee of the American Gastroenterological Association: statement on out-patient liver biopsy. Dig Dis Sci. 1989;34:322–323.

    Article  PubMed  CAS  Google Scholar 

  20. Spiezia S, et al. The efficacy of liver biopsy under ultrasonographic guidance on an outpatient basis. Eur J Ultrasound. 2002;15:127–131.

    Article  PubMed  Google Scholar 

  21. Janes CH, Lindor KD. Outcome of patients hospitalized for complications after outpatient liver biopsy. Ann Intern Med. 1993;118:96–98.

    PubMed  CAS  Google Scholar 

  22. Weigand K, Weigand K. Percutaneous liver biopsy: retrospective study over 15 years comparing 287 inpatients with 428 outpatients. J Gastroenterol Hepatol. 2009;24(5):792–799.

    Article  PubMed  Google Scholar 

  23. Manolakopoulos S, et al. Ultrasound-guided liver biopsy in real life: comparison of same-day prebiopsy versus real-time ultrasound approach. J Gastroenterol Hepatol. 2007;22(9):1490–1493.

    Article  PubMed  Google Scholar 

  24. Sporea I, Popescu A, Sirli R. Why, who and how should perform liver biopsy in chronic liver diseases. World J Gastroenterol. 2008;7(14):3396–3402.

    Article  Google Scholar 

  25. Seef LB et al. Complication rate of percutaneous liver biopsies among persons with advanced chronic liver disease in the HALT-C trial. Clin Gastroenterol Hepatol. 2010 Apr 1 Epub.

  26. Howard R, et al. Post-procedure surveillance in liver biopsy: how long is enough? N Z Med J. 2008;121(1280):8–14.

    PubMed  Google Scholar 

  27. Firpi RJ, et al. Short recovery time after percutaneous liver biopsy: should we change our current practices? Clin Gastroenterol Hepatol. 2005;3(9):926–929.

    Article  PubMed  Google Scholar 

  28. Zubarik R, et al. Prospective analysis of complications 30 days after outpatient colonoscopy. Gastrointest Endosc. 1999;50(3):322–328.

    Article  PubMed  CAS  Google Scholar 

  29. Sugano S, et al. Incidence of ultrasound-detected intrahepatic hematomas due to Tru-cut needle liver biopsy. Dig Dis Sci. 1991;36(9):1229–1233.

    Article  PubMed  CAS  Google Scholar 

  30. Gilmore IT, et al. Indications, methods, and outcomes of percutaneous liver biopsy in England and Wales: an audit by the British Society of Gastroenterology and the Royal College of Physicians of London. Gut. 1995;36:437–441.

    Article  PubMed  CAS  Google Scholar 

  31. The blue book of the European Board of Gastroenterology. http://www.gastrohep.com/eums/UEMS1.pdf.

  32. AGA core curriculum. http://www3.mosby.com/gastro/policy/v110n4p1266.html. Apr 16 2010.

  33. Jonas DE, et al. Patient time requirements for screening colonoscopy. Am J Gastroenterol. 2007;102:2401–2410.

    Article  PubMed  Google Scholar 

  34. Riley TR. Predictors of pain medication use after percutaneous liver biopsy. Dig Dis Sci. 2002;47:2151–2153.

    Article  PubMed  Google Scholar 

  35. Sparchez Z. Complications after percutaneous liver biopsy in diffuse hepatopathies. Rom J Gastro. 2005;14(4):379–384.

    Google Scholar 

  36. Malnick S, Melzer E. Routine ultrasound-guided liver biopsy: a time whose idea has come? J Clin Gastroenterol. 2005;39:900–903.

    Article  PubMed  Google Scholar 

  37. Seeff LB et al. Complications rate of percutaneous liver biopsies among persons with advanced chronic liver disease in the HALT-C trial. Clin Gastroenterol Hepatol. Epub April 2010.

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Correspondence to Jonathan G. Stine.

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Stine, J.G., Liss, G. & Lewis, J.H. The Safety of Same-Day Endoscopy and Percutaneous Liver Biopsy. Dig Dis Sci 56, 1201–1206 (2011). https://doi.org/10.1007/s10620-010-1407-y

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  • DOI: https://doi.org/10.1007/s10620-010-1407-y

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