Safety of Blind Percutaneous Liver Biopsy in Obese Children A Retrospective Analysis

Goal: To determine the safety and adequacy of blind percutaneous liver biopsy (PLB) in obese children. Background: PLB is an important diagnostic tool that, while invasive, enjoys a relatively low major complication rate. An ever increasing reason for pediatric liver biopsy is nonalcoholic fatty liver disease associated with obesity. There is a lack of data assessing the safety of liver biopsy in obese compared to nonobese children. Study: A retrospective study of all children over 5 years of age having PLB was conducted. Data collected included age, gender, weight, height, BMI, reason for biopsy, number of passes, biopsy length, number of portal triads per biopsy, and complication rates. Results: A total of 107 biopsies were reviewed. All biopsies were successful. Overall, major complications occurred in 1.3% and minor complications in 8.4%; there were no deaths. Comparison revealed no difference for number of passes (1.5 +/- 0.7 vs. 1.7 +/- 0.7), biopsy length (2.0 +/- 1.3 cm vs. 1.5 +/- 1.1 cm), number of portal tracts per biopsy (9.8 +/- 5.8 vs. 9.9 +/- 3.4), or complication rates (major: 0% vs. 1.3%; minor: 10.0% vs. 7.8%) between obese and nonobese children. Conclusion: Blind PLB can be safely carried out in obese children with no increase in complication rate compared with nonobese children. Similarly, there is no difference in number of passes, biopsy size, portal triads per biopsy, or biopsy success for obese children.