Experience of Day-Case Transcutaneous Liver Biopsies Performed in a Single Unit

Background: Though an accepted procedure internationally, day-case liver biopsy is not widely practiced in Ireland. Since January 2003 we have been performing day-case liver biopsies in our Unit. We report on our experience to date.

Methods: Suitable patients, with acceptable coagulation profile, FBC and Liver ultrasound, had a transcutaneous liver biopsy performed in Endoscopy Unit (1 procedure performed in Radiology Department). Patients were discharged 6 hours post procedure unless developed complications. Prior to discharge patients were asked to complete a questionnaire – parameters measured were discomfort during and after experience, overall satisfaction with experience. The patients were followed up by phone within 7 days. Hospital records were reviewed to determine indications for biopsy, adequacy of sample and complications.

Results: From January to October 2003 125 procedures were performed in 122 patients. Age range 19–70.

Hepatitis B	10	8%
Hepatitis C	63	52%
Haemochromatosis	15	12%
Abnormal LFTs	33	27%
Liver lesion	1	0.01%

3 patients required repeat biopsy due to an inadequate initial biopsy.

2 patients admitted due to complications:	- 1 perforated gallbladder.
	- 1 chest pain.

95 (78%) patients completed the initial questionnaire. Of these 60 (63%) found procedure uncomfortable, 70 (74%) experienced pain post procedure, 75 (79%) were satisfied with their experience. 82 (86%) would undergo procedure again.

80/95 patients were followed up –39 (49%) experienced pain in the 48 hrs post procedure, mostly described as mild. No late complications were reported.

Conclusion: Overall day-case liver biopsy, for suitable patients, is a safe, well tolerated and cost effective procedure.