What recovery position should patients adopt after percutaneous liver biopsy?

Costa, Rita; Cardoso, A; Ferreira, Aníbal; Costa, Juliana M; Costa, Dalila; Fernandes, Dália; Caetano, Ana Célia

doi:10.1097/meg.0000000000001290

Cited by 3 publications

(6 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our study, the incidence of low blood pressure following the PLB was low (1.5%), similar to previous reports 7,20 . It may occur due to bleeding, vasovagal reflex associated with pain, or even as a side effect of sedative drugs, such as midazolam 4,7,8 .…”

Section: Discussionsupporting

confidence: 92%

“…According to the literature, the patient's position after the PLB does not affect the rate and severity of complications 20 , so our patients decided a comfortable position to rest. At our center, the protocol is to maintain observation for up to 4 to 6 hours after PLB, but the most appropriate period has not been well defined in the literature and it can last from 2 to 8 hours 4,9,[21][22][23] .…”

Section: Discussionmentioning

confidence: 91%

See 1 more Smart Citation

Outpatient Percutaneous Liver Biopsy is a Low-risk Procedure and has Steatosis as a New Indication Trend

Torres

Franson

et al. 2021

Preprint

View full text Add to dashboard Cite

BACKGROUND. Histological evaluation has a crucial role in diagnosing hepatic diseases and percutaneous liver biopsy (PLB) is widely chosen for this purpose. We aim to describe its indications, the rate and severity of adverse events (AEs) in an outpatient and ultrasound (US)-guided setting over 5 years. METHODS. This observational, single-center, and retrospective study included patients submitted to PLB between 2015 and 2019. We collected age, gender, coagulation tests, comorbidities, and number of needle passes. The association between the variables and outcomes (pain, mild and serious AEs, hospital admission, surgical treatment, and death) was evaluated using the generalized estimating equations method. RESULTS. We analyzed 532 biopsies in 524 patients (55.3% male) aged 49y (13–74y). Almost 39% had cardiovascular comorbidities and 18% had overweight/obesity. Hepatitis C virus (HCV) chronic infection was the major indication for PLB (47%), followed by autoimmune hepatitis/cholestasis (12.6%), and metabolic dysfunction-associated fatty liver disease (MAFLD) (12.1%). The number of HCV-related biopsies had a remarkable reduction, while MAFLD-related procedures have progressively raised over time. Around 54% of the patients reported pain, which was significantly associated with the female gender (p=0.0143). Serious AEs occurred in 11 patients (2.1%); hospital admission was necessary in 10 cases (1.9%), but no patient required surgical approach and there were no deaths. No significant association was found between the occurrence of AEs and the studied variables (clinical, laboratory, and number of needle passes). CONCLUSION. Real-time US-guided PLB is safe to perform in an outpatient setting and its indications have notably undergone a transition from HCV to MAFLD over the years. New strategies to prevent biopsy-related pain are still needed, especially for females.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 91%

Outpatient Percutaneous Liver Biopsy is a Low-risk Procedure and has Steatosis as a New Indication Trend

Torres

Franson

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…In a previous study, Chris et al reported no other severe complications except pain (11). In contrast, Rita et al reported the incidence of vasovagal reaction in two cases (2.2%) (10), which was in line with the previous study (17,25). As the two RCTs enrolled in this study involved inadequate cases, we did not observe any complications (e.g., hemorrhage).…”

Section: Discussionsupporting

confidence: 72%

“…In this study, we enrolled two RCTs, and then the metaanalysis was conducted, which showed that the post-PLB pain score in the supine position was significantly lower than that of the combined position at T0. This may be related to the local stimulation-induced pain sensation by RRP or during the body position changes (10,11). There were no statistical differences in the post-PLB pain score among the patients in the supine position, RRP, and CRP at T2 and T4, respectively.…”

Section: Discussionmentioning

confidence: 82%

Effects of Different Recovery Positions on the Postpercutaneous Liver Biopsy Complications: A Metaanalysis

et al. 2021

View full text Add to dashboard Cite

Objective: We aim to evaluate the effects of different recovery positions on the adverse events and the patient acceptability in those who underwent percutaneous liver biopsy (PLB).Methods: A literature search was conducted in the Cochrane Library, Embase, Scopus, PubMed, CNKI, Sinomed, and Wanfang databases. The time for the article extraction was until July 2020. The articles were screened by two independent researchers, together with the bias risk evaluation and data extraction. The RevMan 5.4 software was utilized for the metaanalysis.Results: Finally, two articles involving 180 subjects were eligible for this study. Metaanalysis showed that at T0, the alternation between right-side and combined position (CRP) would induce an elevation of post-PLB pain compared with the dorsal/supine position (SRP) [WMD = −2.00, 95% CI (−3.54, −0.47), p = 0.01]. There were no statistical differences in the postoperative pain among the CRP, SRP, and right-side position (RRP). The patient acceptability of SRP and RRP was higher than that of the CRP. Finally, two eligible studies were included, which showed no incidence of pneumothorax and abdominal bleeding.Conclusions: CRP would induce post-PLB pain at T0. SRP was the most acceptable position for the cases that underwent PLB. There were no statistical differences in the incidence of pneumothorax and abdominal bleeding.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO, identifier: CRD42020196633.

show abstract

“…Most studies were retrospective (20/30, all except [21][22][23][24][25][26][27][28][29]). Most were single-center accounts, with 3 being multi-center studies that nevertheless represented the majority of samples (56,058 of 64,356 biopsies; Table 1).…”

Section: Study and Cohort Characteristicsmentioning

confidence: 99%

Incidence of Complications from Percutaneous Biopsy in Chronic Liver Disease: A Systematic Review and Meta-Analysis

et al. 2021

View full text Add to dashboard Cite

Background Approaches to liver biopsy have changed over the past decade in patients with chronic liver disease. Aims We conducted a systematic review and meta-analysis on the incidence of all complications and technical failure associated with percutaneous liver biopsy. Methods We systematically searched PubMed and the Cochrane Library for cohort studies reporting on complications resulting from liver biopsy published between 2010 and 2020. Studies on participants of any age and sex, who underwent any percutaneous biopsy for non-focal liver disease, were selected. All events except mild pain, minor hematoma, vasovagal episodes, fever and fistula were defined as major complications. Random-effect model meta-analyses with and without covariates were performed, to examine the effect of publication year, patient characteristics, outcome collection, and biopsy type on incidences. Results We identified 30 studies reporting on complications resulting from percutaneous liver biopsy procedures (n = 64,356). Incidence of major complications was 2.44% (95% CI 0.85, 6.75), with mortality at 0.01% (95% CI 0.00, 0.11), hospitalization at 0.65% (95% CI 0.38, 1.11), major bleeding at 0.48% (95% CI 0.22, 1.06), and moderate/severe pain at 0.34% (95% CI 0.08, 1.37). Minor complications at 9.53% (95% CI 3.68, 22.5) were mainly pain at 12.9% (95% CI 5.34, 27.9). Technical failure was high at 0.91% (95% CI 0.27, 3.00). Decreasing patient age significantly increased incidence of hospitalization and major bleeding (P < 0.0001). Hospitalization incidence also significantly increased with disease severity. Conclusions Incidence of major (2.4%) and minor (9.5%) complications, and technical failure (0.91%) in percutaneous liver biopsies continues.

show abstract

What recovery position should patients adopt after percutaneous liver biopsy?

Cited by 3 publications

References 19 publications

Outpatient Percutaneous Liver Biopsy is a Low-risk Procedure and has Steatosis as a New Indication Trend

Outpatient Percutaneous Liver Biopsy is a Low-risk Procedure and has Steatosis as a New Indication Trend

Effects of Different Recovery Positions on the Postpercutaneous Liver Biopsy Complications: A Metaanalysis

Incidence of Complications from Percutaneous Biopsy in Chronic Liver Disease: A Systematic Review and Meta-Analysis

Contact Info

Product

Resources

About