The safety of same-day endoscopy and percutaneous liver biopsy.
OBJECTIVE
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.
Stine
Jonathan G
JG
Department of Medicine, Georgetown University Hospital, 3800 Reservoir Rd NW, 2 Main, Washington, DC 20007, USA. jonathan.stine@gmail.com
Liss
Gordon
G
Lewis
James H
JH
D000328:Adult; D000368:Aged; D001706:Biopsy / Q000009:adverse effects; D003108:Colonic Diseases / Q000175:diagnosis; D004724:Endoscopy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies