Our Summary

This research paper is about the safety and practicality of conducting liver biopsies on children in an outpatient setting, meaning the children won’t have to stay overnight in a hospital. The researchers looked at the medical records of children who had liver biopsies at their hospital from 2005 to 2015. They found that out of 626 biopsies, 30 had complications, with the most common being a type of internal bleeding. However, these complications were identified within 8 hours of the biopsy. The technique used for the biopsy, the size of the needle, or the number of tries to do the biopsy didn’t change the rate of complications. Also, the bleeding complications weren’t related to a blood clotting measure. The study suggests that if children are monitored for 8 hours after a liver biopsy, it can be done safely without a hospital stay. This could save 60 hospital beds and AU$ 80,000 a year.

FAQs

  1. What is the main finding of this research paper on liver biopsies in children?
  2. What were the most common complications found in the study, and when were they typically identified?
  3. How could the practicality of conducting liver biopsies on children in an outpatient setting benefit hospitals financially?

Doctor’s Tip

A doctor might tell a patient that it is important to rest and avoid any strenuous activity for 24-48 hours following a liver biopsy to reduce the risk of bleeding. They may also recommend avoiding taking any blood thinning medications for a certain period of time before the procedure. Additionally, the doctor may advise the patient to drink plenty of fluids to help flush out any sedatives or medications used during the biopsy. Finally, the doctor may suggest monitoring for any signs of infection, such as fever or worsening pain, and to contact them immediately if any concerning symptoms develop.

Suitable For

Patients who are typically recommended for a liver biopsy include:

  1. Patients with suspected liver disease: Liver biopsies are often recommended for patients with abnormal liver function tests, unexplained liver enlargement, or suspected liver diseases such as hepatitis, cirrhosis, or fatty liver disease.

  2. Patients with liver tumors: Liver biopsies may be recommended for patients with suspected liver tumors, such as hepatocellular carcinoma or metastatic liver cancer, to determine the type of tumor and guide treatment decisions.

  3. Patients with unexplained liver abnormalities: Liver biopsies may be recommended for patients with unexplained liver abnormalities, such as elevated liver enzymes or unexplained jaundice, to determine the underlying cause of the abnormalities.

  4. Patients with monitoring chronic liver diseases: Liver biopsies may be recommended for patients with chronic liver diseases, such as hepatitis B or C, to monitor disease progression, assess treatment effectiveness, and guide treatment decisions.

  5. Patients with suspected liver inflammation or fibrosis: Liver biopsies may be recommended for patients with suspected liver inflammation or fibrosis, to assess the extent of inflammation or fibrosis and guide treatment decisions.

Overall, liver biopsy is a valuable diagnostic tool for evaluating liver diseases and guiding treatment decisions in a variety of patient populations.

Timeline

Before the liver biopsy:

  1. The patient’s doctor will discuss the reasons for the biopsy and obtain informed consent.
  2. The patient may need to undergo blood tests and imaging scans to assess the liver’s condition.
  3. The patient may be instructed to avoid eating or drinking for a certain period before the procedure.
  4. The patient will be given instructions on how to prepare for the biopsy and what to expect during and after the procedure.

After the liver biopsy:

  1. The patient will be monitored in a recovery area for a few hours following the procedure.
  2. The patient may experience some discomfort or pain at the biopsy site, which can be managed with pain medication.
  3. The patient will be instructed to rest and avoid strenuous activities for a certain period after the biopsy.
  4. The patient will be advised on any signs of complications to watch for, such as bleeding or infection.
  5. Follow-up appointments may be scheduled to monitor the patient’s recovery and discuss the biopsy results.

What to Ask Your Doctor

  1. What is the purpose of the liver biopsy and what information will it provide about my condition?
  2. What are the potential risks and complications associated with a liver biopsy?
  3. How will the biopsy be performed and what type of anesthesia will be used?
  4. How long will the procedure take and how long will I need to stay in the outpatient setting for observation?
  5. What post-procedure care instructions should I follow and when can I resume normal activities?
  6. Will I need any follow-up appointments or tests after the biopsy?
  7. Are there any specific factors about my medical history or current health condition that could affect the safety or outcome of the biopsy?
  8. What experience does the medical team have with performing liver biopsies in an outpatient setting, particularly on children?
  9. What alternatives to a liver biopsy are available and why is a biopsy recommended in my case?
  10. Are there any specific signs or symptoms I should watch for after the biopsy that may indicate a complication?

Reference

Authors: Bolia R, Matta J, Malik R, Hardikar W. Journal: J Pediatr Gastroenterol Nutr. 2017 Jul;65(1):86-88. doi: 10.1097/MPG.0000000000001565. PMID: 28644355