Major complications after ultrasound-guided liver biopsy: An annual audit of a Chinese tertiary-care teaching hospital

BACKGROUNDAs ultrasound-guided percutaneous liver biopsy (PLB) has become a standard and important method in the management of liver disease in our country, a periodical audit of the major complications is needed.AIMTo determine the annual incidence of major complications following ultrasound-guided PLB and to identify variables that are significantly associated with an increased risk of major complications.METHODSA total of 1857 consecutive cases of PLB were included in our hospital from January 2021 to December 2021. The major complication rate and all-cause 30-d mortality rate were determined. Multivariate analyses were performed by logistic regression to investigate the risk factors associated with major complications and all-cause 30-d mortality following ultrasound-guided PLB.RESULTSIn this audit of 1857 liver biopsies, 10 cases (0.53%) of major complications occurred following ultrasound-guided PLB. The overall all-cause mortality rate at 30 d after PLB was 0.27% (5 cases). Two cases (0.11%) were attributed to major hemorrhage within 7 d after liver biopsy. Fibrinogen less than 2 g/L [odds ratio (OR): 17.226; 95% confidence interval (CI): 2.647-112.102; P = 0.003], post-biopsy hemoglobin level (OR: 0.963; 95%CI: 0.942-0.985; P = 0.001), obstructive jaundice (OR: 6.698; 95%CI: 1.133-39.596; P = 0.036), application of anticoagulants/antiplatelet medications (OR: 24.078; 95%CI: 1.678-345.495; P = 0.019) and age (OR: 1.096; 95%CI: 1.012-1.187; P = 0.025) were statistically associated with the incidence of major complications after PLB.CONCLUSIONIn conclusion, the results of this annual audit confirmed that ultrasound-guided PLB can be performed safely, with a major complication rate within the accepted range. Strict patient selection and peri-biopsy laboratory assessment are more important than procedural factors for optimizing the safety outcomes of this procedure.

Automated summary

This study aimed to determine the annual incidence of major complications following ultrasound-guided percutaneous liver biopsy (PLB) and identify variables associated with an increased risk of major complications. A total of 1857 consecutive cases of PLB were included in the study, and the major complication rate was found to be 0.53%, with a 30-day all-cause mortality rate of 0.27%. Factors associated with the incidence of major complications after PLB included fibrinogen less than 2 g/L, post-biopsy hemoglobin level, obstructive jaundice, application of anticoagulants/antiplatelet medications, and age.