title: Effect of operator experience and frequency of procedure performance on complication rate after ultrasound-guided percutaneous liver biopsies.
abstract: OBJECTIVE
  The aim of the present study was to assess whether the complication rate after ultrasound-guided percutaneous liver biopsies in children is affected by how frequently the procedure is performed by the operator.
  
  
  METHODS
  Medical charts and ultrasound descriptions of 311 ultrasound-guided percutaneous liver biopsy procedures performed by 18 radiologists at a single center from 2000 to 2011 were reviewed. Postbiopsy ultrasound the following day was performed after 97% of the procedures.
  
  
  RESULTS
  There were no differences in the procedure-associated rate of major bleeding incidents (2.2% vs 0.8%, P = 0.38), minor bleeding incidents (15.2% vs 10.2%, P = 0.31), or abdominal pain (13.0% vs 10.6%, P = 0.61) among operators who performed ≤10 procedures and those who performed >10 procedures during the study period. A higher rate of minor bleeding incidents were recorded after liver biopsy when operators had performed <10 biopsies compared with operators who had performed >20 pediatric liver biopsies during the study period (odds ratio 3.4 [1.3-9.1], P = 0.02). No association between the number of biopsies performed by the operator during the 2 years preceding the date of the biopsy and complications was found.
  
  
  CONCLUSIONS
  Major complications are infrequent after pediatric liver biopsies and no relation between operator experience and major complications was found. We found a significant, but minor, effect of operator procedure frequency on the rate of minor bleeding incidents after ultrasound-guided pediatric liver biopsies.
authors.affiliation: *Department of Pediatric Research, Women and Children's Division †Department of Radiology, Rikshospitalet, Oslo University Hospital ‡Department of Paediatric Medicine, Women and Children's Division, Oslo University Hospital, Oslo, Norway.
authors.forename: Birgitte H
authors.initials: BH
authors.lastname: Westheim
authors.forename: Ingegerd
authors.initials: I
authors.lastname: Aagenæs
authors.forename: Anniken B
authors.initials: AB
authors.lastname: Østensen
authors.forename: Truls
authors.initials: T
authors.lastname: Sanengen
authors.forename: Runar
authors.initials: R
authors.lastname: Almaas
mesh_terms: D015746:Abdominal Pain / Q000453:epidemiology / Q000517:prevention & control; D000293:Adolescent; D001707:Biopsy, Needle / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence; D016145:Endoscopy, Digestive System / Q000009:adverse effects*; D006785:Hospitals, University; D006801:Humans; D061705:Image-Guided Biopsy / Q000009:adverse effects*; D015994:Incidence; D007223:Infant; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology*; D016031:Liver Transplantation / Q000009:adverse effects; D009664:Norway / Q000453:epidemiology; D010149:Postoperative Pain / Q000453:epidemiology / Q000517:prevention & control; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control*; D019106:Postoperative Hemorrhage / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control; D015642:Radiology, Interventional; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D014463:Ultrasonography; D000078329:Workforce