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Volume : 08, Issue : 01, January – 2021
123.SAFETY OF OUTPATIENT BLIND PERCUTANEOUS LIVER BIOPSY (OBPLB) IN CHILDREN AND DOCUMENTATION OF THE SPECTRUM OF CHILDHOOD LIVER DISEASE
Dr Kiran Fida, Dr Mohsin Iqbal, Dr Eman Madnia
Abstract :
Aim: To determine the safety of Outpatient Blind Percutaneous Liver Biopsy (OBPLB) in children and to document the spectrum of pediatric liver disease.
Material and Methods: This retrospective study was conducted in the Department of Pediatric Gastroenterology, Sir Ganga Ram Hospital Lahore for three-year duration from November 2017 to November 2020. Liver biopsies were performed using the Menghini aspiration technique. Histological diagnosis was documented. Complications were classified into minor (excessive crying and / or irritability, pain at the biopsy site, excessive sedation, and minor external hemorrhage from the biopsy site) or major (major external biopsy site hemorrhage, intraperitoneal hemorrhage, intrahepatic bleeding, biliary peritonitis, haemobilia, injury lungs, shock and death).
Results: Seven hundred and sixty-eight biopsies were performed on an outpatient basis in our department over the period of 3 years. Five hundred and five (65.8%) are men and 263 (34.2%) are women. The age range was from one month to 16 years. The liver biopsy fragment was diagnostic in 700 (91.1%) of the cases, 4.6% of the biopsies were normal, and 4.3% of the biopsies were inconclusive. The most common histological diagnosis was neonatal hepatitis (20.3%), followed by a decreasing frequency of chronic hepatitis (14.3%), glycogen storage disorders (13.7%), biliary atresia (13.4%), steatosis (10.8%), progressive familial intrahepatic cholestasis. (6.6%), lipid storage disorder (4.8%), cirrhosis 17 (2.2%), granulomatous hepatitis (0.7%), secondary haemochromatosis (0.7%), hepatosplenic aspergillosis (0.4%) and hepatoma (0.4%). One patient was diagnosed with each hepatocellular carcinoma, sclerosing hemangioma, metastatic non-Hodgkin’s lymphoma, biliary cyst, cholangitis, and Budd-Chiari syndrome (0.1%). Seven (0.7%) biopsies were performed in six patients after liver transplantation. In our study, 45 had minor complications (5.8%) and no major complications were observed.
Conclusion: This study suggests that ambulatory percutaneous liver biopsy is relatively safe and well-tolerated with minimal complications in young infants and older children, and the results provide important diagnostic information. The most common histological diagnoses were neonatal hepatitis, chronic hepatitis, glycogen storage disorders, biliary atresia, steatosis, and progressive familial intrahepatic cholestasis.
Keywords: liver biopsy, ambulatory, percutaneous, histological diagnostics
Cite This Article:
Please cite this article in press Kiran Fida et al, Safety Of Outpatient Blind Percutaneous Liver Biopsy (Obplb) In Children And Documentation Of The Spectrum Of Childhood Liver Disease., Indo Am. J. P. Sci, 2021; 08(1).