Ambulatory liver biopsy: complications and evolution in 264 cases.
OBJECTIVE
To determine the safety and acceptance of outpatient liver biopsies.


METHODS
Data from all liver biopsies were collected in a prospective way over a period of 18 months. Information was gathered on complications, evolution of patients outside the hospital and opinion relating to the test. All patients were required to previously present: platelet count > 60.000/mm3 prothrombin time within 4 seconds of control and absence of ascites or encephalopathy. Criteria for outpatient liver biopsy also included cooperative patient, a partner or friend who stayed with the patient during 12-24 hours following the test and easy access to the hospital. Out of a total of 378 biopsies, 264 (70%) were ambulatory.


RESULTS
Five of the 264 outpatients were hospitalized (1.9%), due to a subcapsular hematoma in one case, persistent pain in 3 cases and sever hypotension in the other; all of them evolved favorably in the first 24 hours. Among the inpatients, 2 had complications (1.7%): one subcapsular hematoma resolved without treatment and one abdominal hemorrhage requiring transfusion. Of the ambulatory patients, 46 (18%) presented pain whilst at home, being more frequent in females than in males (30% vs 15%, p = 0.004) and in those who needed more than one attempt to obtain histological material compared with those of a single attempt (33% vs 17%; p = 0.008). Twenty four hours after the test, 83% of the patients had returned to their normal activities. Ninety five percent of the patients questioned considered that the test was not traumatic, and 88% stated a preference for liver biopsy as a day case procedure.


CONCLUSIONS
Liver biopsy performed on an ambulatory basis is safe, well tolerated and acceptable by the majority of patients.
Vivas
S
S
Gastroenterology Unit, Hospital Central de Asturias, Oviedo, Spain.
Palacio
M A
MA
Rodríguez
M
M
Lomo
J
J
Cadenas
F
F
Giganto
F
F
Rodrigo
L
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000009:adverse effects; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D011446:Prospective Studies