Ultrasound-assisted percutaneous liver biopsy performed by a physician assistant

Timothy J. Gunneson, K. V. Narayanan Menon, Russell H. Wiesner, Judith A. Daniels, J. Eileen Hay, Michael R. Charlton, David J. Brandhagen, Charles B. Rosen, Michael K. Porayko

Research output: Contribution to journalArticlepeer-review

49 Scopus citations

Abstract

OBJECTIVE: Percutaneous liver biopsy is an essential diagnostic tool utilized in the management of patients with liver disease. This procedure is generally performed by a physician and has a small but well-defined complication rate. We report on the complication rate and efficiency of ultrasound-assisted percutaneous liver biopsy performed by an experienced physician assistant. METHODS: One thousand eighty-six consecutive outpatient liver biopsies (847 hepatic allografts and 239 native livers) were performed at a single center by a physician assistant between June, 1996 and June, 2000. Patients with hepatic mass lesions, unusual hepatic anatomy, and uncorrectable coagulopathy (international normalized ratio > 1.7, platelet count < 50 × 109/L) were excluded. Bedside ultrasonography was used to determine the optimal site for the liver biopsy. Liver biopsies were performed with a 15-gauge Jamshidi aspiration biopsy needle. Patients were observed for 3 h after biopsy, followed by dismissal with subsequent contact in 24 h to assess outcome and complications. RESULTS: Adequate tissue was obtained in 1084 cases (99.8%), with a mean tissue length of 3.2 cm. After the procedure, narcotic analgesia was necessary in 116 (10%) of the patients undergoing liver biopsies. The overall complication rate requiring hospitalization was 0.6%. Major complications requiring intervention occurred in four patients (0.4%). There were no deaths resulting from liver biopsies. CONCLUSION: We conclude that outpatient percutaneous liver biopsy can be safely and effectively performed by a trained physician assistant.

Original languageEnglish (US)
Pages (from-to)1472-1475
Number of pages4
JournalAmerican Journal of Gastroenterology
Volume97
Issue number6
DOIs
StatePublished - Jul 2 2002

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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