Post-procedure surveillance in liver biopsy: how long is long enough?
OBJECTIVE
To assess the incidence of complications following liver biopsy and the impact of pre-procedural pethidine on complications and analgesia administration.


METHODS
A retrospective audit of percutaneous liver biopsies undertaken at Dunedin Public Hospital (2001-2006). Patients' medical files were consulted for demographics, biopsy indication, complications, frequency, and timing of analgesia.


RESULTS
447 biopsies were analysed. Primary indications included: hepatitis C (38.8%), abnormal liver function tests (18.3%), methotrexate therapy (12.5%), and malignancy (10.3%). 303 (68%) biopsies resulted in no complications. Major complications were not experienced. Minor complications included: pain (32.2%), hypotension (1.3%), nausea/vomiting (0.9%), and alcohol withdrawal (0.2%). More females (47%) than males (31%) reported complications. Post-procedural analgesia was administered in 31% of biopsies; only 9% required analgesia more than 2 hours after biopsy. Patients who had pre-procedural pethidine experienced similar rates of complications as patients not receiving pre-procedural pethidine, but received less post-procedural opiate analgesia.


CONCLUSIONS
No major complications occurred, whilst the rate of minor complications was comparable with previous studies. Pain was the most common complication, although use of analgesia after 2 hours of observation was low. Our findings suggest that post-procedural observation may safely be reduced to two hours but it is currently unknown if early mobilisation following discharge will lead to complications.
Howard
Rowena
R
Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
Karageorge
George
G
van Harselaar
Kate
K
Bell
Melanie
M
Basford
Pete
P
Schultz
Michael
M
Derrett
Sarah
S
D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use; D001706:Biopsy / Q000009:adverse effects*; D002492:Central Nervous System Depressants / Q000009:adverse effects; D003266:Continuity of Patient Care; D004363:Drug Utilization; D000431:Ethanol / Q000009:adverse effects; D005260:Female; D006801:Humans; D007022:Hypotension / Q000209:etiology; D008099:Liver / Q000473:pathology*; D008107:Liver Diseases / Q000175:diagnosis; D008297:Male; D008485:Medical Audit; D008614:Meperidine / Q000627:therapeutic use; D008875:Middle Aged; D009325:Nausea / Q000209:etiology; D010146:Pain / Q000188:drug therapy / Q000209:etiology; D012189:Retrospective Studies; D012737:Sex Factors; D013375:Substance Withdrawal Syndrome / Q000209:etiology; D013997:Time Factors; D014839:Vomiting / Q000209:etiology
D000701:Analgesics, Opioid; D002492:Central Nervous System Depressants; D000431:Ethanol; D008614:Meperidine