P0282 THE SAFETY OF OUTPATIENT PERCUTANEOUS LIVER BIOPSY IN CHILDREN

Abstract

Introduction: Percutaneous liver biopsy is a standard procedure in investigating children and adults with liver disease. Out-patient percutaneous liver biopsy (OPLB) in adults has been described since 1978 with increasing experience to utilize the out-patient setting in order to decrease the procedure related cost. The experience in children is limited. Methods: This is a retrospective study. The charts of children <18 years of age who underwent outpatient percutaneous liver biopsy were reviewed. Age, sex, diagnosis, observation period and procedure were reviewed. Results: Between September 1994 and September 2003, a total of 96 patients were booked for OPLB, 2 were cancelled because of low platelet count. The age range was 5 months to 18 years (mean 9.72), male:female ratio 3.5:1. After informed consent, 6 patients were done under ultrasound guidance, the remaining 86 were done blindly using Menghini Needle (1.2–1.4 mm Hepafix). Eighty two patients required one pass, 11 patients required 2 passes and 1 patient required 3 passes. The post biopsy observation time was 5–10 hours (mean 6 hours). Seven patients required no sedation (15–18 years of age), while 3 patients needed IV Ketamine with anesthesiologist assistance. The remaining 84 patients were sedated with IV meperidine 1–2.2 mg/kg and IV midazolam 0.1–0.3 mg/kg. All patients had local 1% Xylocaine injection at the biopsy site. All patients had a platelet count of >100,000 and normal PT, PTT and had blood typed and screened. Minor complications were encountered in 4 patients with mild to moderate pain at the site of the biopsy, which needed simple pain killer (2 patients received no IV sedation). Two patients had a mild drop in their systolic blood pressure and needed IV normal saline bolus 20 cc/kg. No major complications were encountered. Conclusion: We conclude that OPLB in children is a safe and cost effective procedure.