Incidence and Predictors of Complications Following Percutaneous Liver Biopsy: A Large Italian Multicentre Study

IF 6 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Liver International Pub Date : 2025-04-01 DOI:10.1111/liv.70078

Francesca Colapietro, Mauro Viganò, Federica Cerini, Riccardo Plebani, Alberto Savino, Maria Pia Calabrese, Paolo Marra, Kessy Djonis Martins de Mattos, Sara Taboni, Agostino Cosenza, Alessandro Loglio, Carmelo Selvaggio, Maria Grazia Lucà, Chiara Masellis, Benedetta Mori, Nicola Pugliese, Chiara Masetti, Elisa Farina, Stella De Nicola, Roberto Ceriani, Ana Lleo, Riccardo Muglia, Sandro Sironi, Stefano Fagiuoli, Alessio Aghemo

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引用次数: 0

Abstract

Background and Aims

Management of ultrasound (US)-guided percutaneous liver biopsy (PLB) lacks standardisation. Despite the low risk of major complications (< 1%), repeated blood counts and up to 4 h of in-hospital observation are typically recommended. We aimed to assess complication rates and predictors in a large cohort of patients undergoing US-PLB across three Italian tertiary centres. We included all patients undergoing US-PLB from January 2018 to December 2023. We collected clinical, biochemical and procedural features (needle type, insertions number, observation time and antiplatelet/anticoagulant regimens). Safety was assessed by the incidence of pain and major complications, including vasovagal reaction, bleeding, pneumothorax, shock, hospitalisation and death.

Approach and Results

Among 1838 patients (mean age 55.1 years, 46.1% females, mean BMI 25.1 kg/m², 74% parenchymal PLB), few were on anticoagulant/antiplatelet therapy (4.2%/16.2%); mean platelet count and PT INR were 209.7 × 10³/mm³ and 1.04; 17 patients (0.9%) received prophylactic therapy (blood components, thrombopoietin receptor agonists or vitamin K). Needle aspiration was predominant (92%). During a mean time of observation of 5.4 ± 2.0 h, 134/1838 patients reported pain (7.4%). Major complications were few (26, 1.4%), with 14 episodes of transient hypotension (0.8%); 10 bleeding events (0.5%); 1 pneumothorax; 1 abscess formation; 1 haemobilia; and 1 episode of chest pain. Hospitalisation was rare (12, 0.7%), primarily for bleeding management. No fatalities were recorded. Pain was the sole significant independent predictor of major complications (18/26, HR 30.6, p < 0.05), particularly when reported within the first hour post-procedure (15/18, 83.3%).

Conclusions

Major complications following US-PLB are few and strongly associated with early post-procedural pain. In the absence of pain within the first hour, extended monitoring may be unnecessary, allowing for earlier patient discharge.

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经皮肝活检术后并发症的发生率和预测因素：一项大型意大利多中心研究

背景与目的超声引导下经皮肝活检（PLB）的处理缺乏标准化。尽管发生主要并发症的风险较低（1%），但通常建议重复血液计数和长达4小时的住院观察。我们的目的是评估意大利三个三级中心接受US-PLB的大队列患者的并发症发生率和预测因素。我们纳入了2018年1月至2023年12月期间接受US-PLB的所有患者。我们收集临床、生化和程序特征（针型、插入次数、观察时间和抗血小板/抗凝方案）。安全性通过疼痛和主要并发症的发生率来评估，包括血管迷走神经反应、出血、气胸、休克、住院和死亡。方法与结果在1838例患者中（平均年龄55.1岁，女性占46.1%，平均BMI 25.1 kg/m2，实质PLB占74%），接受抗凝/抗血小板治疗的患者很少（4.2%/16.2%）；平均血小板计数为209.7 × 103/mm3， PT INR为1.04；17例患者（0.9%）接受了预防性治疗（血液成分、血小板生成素受体激动剂或维生素K）。针吸治疗占主导地位（92%）。平均观察时间为5.4±2.0 h， 1838例患者中有134例出现疼痛（7.4%）。主要并发症很少（26例，1.4%），一过性低血压14次（0.8%）；出血事件10例（0.5%）；1气胸;脓肿形成1例；1 haemobilia;还有一次胸痛。住院是罕见的（12.0.7%），主要是出血处理。没有死亡记录。疼痛是主要并发症的唯一显著独立预测因子（18/26,HR 30.6, p < 0.05），尤其是在术后1小时内报告的疼痛（15/18,83.3%）。结论US-PLB术后的主要并发症很少，且与早期术后疼痛密切相关。如果在第一个小时内没有疼痛，延长监测可能是不必要的，允许患者早期出院。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Liver International 医学-胃肠肝病学

CiteScore

13.90

自引率

4.50%

发文量

348

审稿时长

2 months

期刊介绍： Liver International promotes all aspects of the science of hepatology from basic research to applied clinical studies. Providing an international forum for the publication of high-quality original research in hepatology, it is an essential resource for everyone working on normal and abnormal structure and function in the liver and its constituent cells, including clinicians and basic scientists involved in the multi-disciplinary field of hepatology. The journal welcomes articles from all fields of hepatology, which may be published as original articles, brief definitive reports, reviews, mini-reviews, images in hepatology and letters to the Editor.