Ultrasound-assisted percutaneous liver biopsy performed by a physician assistant.
OBJECTIVE
Percutaneous liver biopsy is an essential diagnostic tool utilized in the management of patients with liver disease. This procedure is generally performed by a physician and has a small but well-defined complication rate. We report on the complication rate and efficiency of ultrasound-assisted percutaneous liver biopsy performed by an experienced physician assistant.


METHODS
One thousand eighty-six consecutive outpatient liver biopsies (847 hepatic allografts and 239 native livers) were performed at a single center by a physician assistant between June, 1996 and June, 2000. Patients with hepatic mass lesions, unusual hepatic anatomy, and uncorrectable coagulopathy (international normalized ratio > 1.7, platelet count < 50 x 10(9)/L) were excluded. Bedside ultrasonography was used to determine the optimal site for the liver biopsy. Liver biopsies were performed with a 15-gauge Jamshidi aspiration biopsy needle. Patients were observed for 3 h after biopsy, followed by dismissal with subsequent contact in 24 h to assess outcome and complications.


RESULTS
Adequate tissue was obtained in 1084 cases (99.8%), with a mean tissue length of 3.2 cm. After the procedure, narcotic analgesia was necessary in 116 (10%) of the patients undergoing liver biopsies. The overall complication rate requiring hospitalization was 0.6%. Major complications requiring intervention occurred in four patients (0.4%). There were no deaths resulting from liver biopsies.


CONCLUSIONS
We conclude that outpatient percutaneous liver biopsy can be safely and effectively performed by a trained physician assistant.
Gunneson
Timothy J
TJ
Transplant Center, Mayo Clinic and Foundation, Rochester, Minnesota 55905, USA.
Menon
K V Narayanan
KV
Wiesner
Russell H
RH
Daniels
Judith A
JA
Hay
J Eileen
JE
Charlton
Michael R
MR
Brandhagen
David J
DJ
Rosen
Charles B
CB
Porayko
Michael K
MK
D001706:Biopsy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D010823:Physician Assistants; D011446:Prospective Studies; D014463:Ultrasonography