Outpatient Percutaneous Liver Biopsy in Children

Gonzalez-Vallina, Ruben; Alonso, Estella M.; Rand, Elizabeth B.; Black, Dennis D.; Whitington, Peter F.

doi:10.1097/00005176-199311000-00006

Cited by 46 publications

(41 citation statements)

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“…In a study closely related to ours, Gonzalez-Vallina et al [1] compared complication rates for 184 outpatient percutaneous liver biopsies in children over a 4-year period with a group of 521 inpatient percutaneous liver biopsies. In this series, four complications were noted: 2 patients with respiratory depression from the sedation and 2 specimens which did not have adequate tissue in the 184 outpatient biopsies.…”

Section: Discussionmentioning

confidence: 99%

“…With the rising cost of health care, many institutions are seeking shorter hospital stays and utilizing the outpatient area for what were previously inhouse procedures, as well as for observation and monitoring of common illnesses [1]. Currently, the standard of practice for children undergoing a percutaneous renal biopsy is to have the child admitted to the hospital on day 1, before or after the procedure, then observation of the child overnight to be discharged the next morning pending lack of complications.…”

Section: Introductionmentioning

confidence: 99%

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Safety and cost effectiveness of pediatric percutaneous renal biopsy

Chesney

Brouhard

Cunningham

1996

Pediatric Nephrology

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Because of the rising cost of health care, more patients are undergoing procedures as outpatients rather than inpatients. The purpose of this study was to compare safety and cost of outpatient versus inpatient, overnight stay, for children undergoing percutaneous renal biopsy. Charts of all such patients between January 1989 through January 1995 were reviewed for the following: age of patient, native versus allograft biopsy and preparation costs (in 1995 U.S. dollars), and complications. Of the 75 biopsies reviewed, 58 were native and 17 allograft with 35 (47%) of the biopsies being outpatient and 40 (53%) inpatient. There were four complications (11.4%) in 2 patients for the outpatient group and seven complications (17.5%) in 6 patients in the inpatient group (X2 = 0.1003, P = 0.75). The median cost for an outpatient biopsy was U.S. $1,968 while an inpatient biopsy was U.S. $3,178. We conclude that outpatient percutaneous renal biopsy in children is as safe as inpatient and more economic, with a saving of greater than U.S. $1,000 per biopsy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Safety and cost effectiveness of pediatric percutaneous renal biopsy

Chesney

Brouhard

Cunningham

1996

Pediatric Nephrology

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“…Complications of LB (Tables 1 and 2) (63,(79)(80)(81)(82)(83)(84) are usually considered to be ''major'' or ''minor.'' We consider ''minor'' complications to include pain, subcapsular bleeding that does not require transfusion or prolonged hospitalisation, infection, minor bile leak or haemobilia, and arteriovenous fistula.…”

Section: Complications Of Lbmentioning

confidence: 99%

“…Low-molecular-weight heparin use (79) Focal lesion (79) Acute liver failure (79) Infants age <3 months (79,80) Massive ascites (81) Thrombocytopaenia (82) Previous malignancy or bone marrow transplantation (81,82) Chronic renal failure (83) Biliary tract dilatation (84) adults is extremely low (104). Nevertheless, and of relevance to paediatric practice, the incidence of sepsis after LB is higher in adult liver transplant recipients who underwent choledochojejunostomy than in recipients with direct bile duct to bile duct anastomosis (104).…”

Section: Risk Factor For Minor or Major Complicationsmentioning

confidence: 99%

Liver Biopsy in Children

Dezsőfi

Baumann²,

Dhawan

et al. 2015

J. pediatr. gastroenterol. nutr.

179

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Liver biopsy (LB) is still the criterion standard procedure for obtaining liver tissue for histopathological examination and a valuable tool in the diagnosis, prognosis, and management of many parenchymal liver diseases. The aim of this position paper is to summarise the present practice of paediatric LB and make recommendations about its performance. Although histological evaluation of the liver is important in assessing prognosis and exploring treatment, noninvasive techniques (ie, imaging, laboratory markers) may replace use of liver histology. The indications for LB are changing as present knowledge of aetiologies, pathomechanism, and therapeutic options in paediatric liver disease is evolving. Adult and paediatric literature was reviewed to assess the existing clinical practice of LB with focus on the technique, indications, risk of complications, and contraindications in paediatrics. This position paper presents types of LB, indications, complications, contraindications, and an essential checklist for paediatric LB.

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“…In reality even if the development of non-invasive markers of liver injury must be encouraged especially for the assessment of liver fibrosis, the consensus in many conference statements recommend liver biopsy for the diagnosis and the management of almost all patients with liver diseases (15)(16)(17)(18). To date liver biopsy has three major roles: for diagnosis, for assessment of prognosis (disease staging), and/ or to assist in making therapeutic management decisions.…”

Section: Indications For Liver Biopsy In Children Overviewmentioning

confidence: 99%