Short recovery time after percutaneous liver biopsy: should we change our current practices?
OBJECTIVE
Percutaneous liver biopsy is the gold standard in the diagnosis and staging of a wide variety of hepatic disorders. Complications, post-procedure monitoring, and recovery time have limited the ability for liver biopsies to be performed in a busy gastroenterology community practice. The aim of this study was to determine whether ambulatory patients requiring percutaneous liver biopsy can be safely discharged after a short recovery time period.


METHODS
All ambulatory patients undergoing a percutaneous liver biopsy at the University of Florida between February 1995 and June 2004 were evaluated in this study. A 15-gauge Jamshidi needle was used after percussion (before February 2002) or ultrasound guidance (starting February 2002). Major complications were defined as those events that required either immediate or delayed hospitalization or resulted in death within 2 weeks after the liver biopsy.


RESULTS
Three thousand two hundred fourteen outpatient liver biopsies were performed at our institution from March 1995 to June 2004. During this time, our recovery time was gradually decreased from 6 hours before 1997 to 1 hour in 2002. The majority of the complications occurred within 1 hour of the observation period or within 24 hours after discharge. The major complication rate was < or =1.7%, regardless of the observation period.


CONCLUSIONS
A shorter observation time after ambulatory percutaneous liver biopsy is safe and might facilitate the physician's ability to optimally utilize procedural space and ancillary staff in a busy ambulatory care unit.
Firpi
Roberto J
RJ
Division of Gastroenterology, Hepatology and Nutrition Section of Hepatobiliary Diseases, University of Florida, 1600 SW Archer Road, PO Box 100214, Gainesville, FL 32610-0214, USA. firpirj@medicine.ufl.edu
Soldevila-Pico
Consuelo
C
Abdelmalek
Manal F
MF
Morelli
Giuseppe
G
Judah
Joel
J
Nelson
David R
DR
D001707:Biopsy, Needle / Q000009:adverse effects* / Q000191:economics; D016063:Blood Loss, Surgical / Q000503:physiopathology / Q000706:statistics & numerical data; D015331:Cohort Studies; D005431:Florida / Q000453:epidemiology; D006491:Hemothorax / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D015994:Incidence; D007902:Length of Stay; D008107:Liver Diseases / Q000175:diagnosis* / Q000473:pathology; D010149:Postoperative Pain / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D010351:Patient Discharge; D020127:Recovery of Function; D012720:Severity of Illness Index; D013997:Time Factors
D006993:Hypnotics and Sedatives