What are the AGA guidelines on percutaneous liver biopsy?

Updated: Nov 21, 2019
  • Author: Gaurav Arora, MD, MS; Chief Editor: Kurt E Roberts, MD  more...
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Answer

Generally, performance of percutaneous liver biopsy should adhere to the following guidelines, which are modified from the American Gastroenterological Association’s 1989 position statement [10] :

  • The patient must be able to easily return to the hospital where the procedure was performed within 30 minutes of developing any adverse symptoms
  • A reliable individual must be available to stay with the patient during the first night after the liver biopsy and provide care and transportation to the hospital, if necessary
  • The patient should not have any preexisting serious medical problems that might increase the risk of complications from the biopsy (eg, encephalopathy, ascites, liver failure with severe jaundice, significant extrahepatic obstruction, significant coagulopathies, or serious comorbidities such as severe congestive heart failure); also, patients should not be very old, very young, or so anxious that they require sedation
  • The facility where the biopsy is to be performed should have an approved laboratory, blood banking unit, easy access to an inpatient bed, and personnel to monitor the patient for 6 hours after the biopsy (however, according to recommendations from the American Association for the Study of Liver Diseases [AASLD], a period of 2-4 hours may suffice [11] )
  • The patient should be hospitalized after biopsy if any evidence exists of bleeding, bile leak, pneumothorax, or other organ puncture; hospitalization is suggested if the patient’s pain requires more than one dose of an analgesic in the first 4 hours after the biopsy

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