Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 22 (4), 377-386

Same-Day Versus Overnight Observation After Outpatient Pediatric Percutaneous Liver Biopsy: A Retrospective Cohort Study


Same-Day Versus Overnight Observation After Outpatient Pediatric Percutaneous Liver Biopsy: A Retrospective Cohort Study

Svetlana Yuryevna Kozlovich et al. Pediatr Gastroenterol Hepatol Nutr.


Purpose: Percutaneous liver biopsy (PLB), a diagnostic procedure to identify several hepatobiliary disorders, is considered safe with low incidence of associated complications. While postoperative monitoring guidelines are suggested for adults, selection of procedural recovery time for children remains at the discretion of individual operators. We aim to determine if differences exist in frequency of surgical complications, unplanned admissions, and healthcare cost for children undergoing outpatient PLB for cohorts with same-day vs. overnight observation.

Methods: We performed a retrospective cohort study in children 1 month to 17 years of age undergoing ultrasound-guided PLB from January 2009 to August 2017 at a tertiary care, pediatric referral center. Cohorts were defined by postprocedural observation duration: same-day (≤8 hours) vs. overnight observation. Outcomes included surgical complications, medical interventions, unscheduled hospitalization within 7 days, and total encounter costs.

Results: One hundred and twelve children met study criteria of which 18 (16.1%) were assigned to same-day observation. No differences were noted in demographics, anthropometrics, comorbidities, biopsy indications, or preoperative coagulation profiles. No major complications or acute hospitalizations after PLB were observed. Administration of analgesia and fluid boluses were isolated and given within 8 hours. Compared to overnight monitoring, same-day observation accrued less total costs (US $992 less per encounter).

Conclusion: Same-day observation after PLB in children appears well-tolerated with only minor interventions and complications observed within 8 hours of procedure. We recommend a targeted risk assessment prior to selection of observation duration. Same-day observation appears an appropriate recovery strategy in otherwise low-risk children undergoing outpatient PLB.

Keywords: Biopsy; Complications; Cost effectiveness; Liver; Observation; Safety.

Conflict of interest statement

Conflict of Interest: The authors have no financial conflicts of interest.


Fig. 1
Fig. 1. Box and whisker plot of total encounter costs following percutaneous liver biopsy for children with same-day vs. overnight observation.

Similar articles

See all similar articles


    1. Bilreiro C, Noruegas MJ, Gonçalves I, Moreira Â. Ultrasound-guided liver biopsies in children: a single-center experience and risk factors for minor bleeding. J Pediatr Gastroenterol Nutr. 2017;65:137–140. - PubMed
    1. Copel L, Sosna J, Kruskal JB, Kane RA. Ultrasound-guided percutaneous liver biopsy: indications, risks, and technique. Surg Technol Int. 2003;11:154–160. - PubMed
    1. Bolia R, Matta J, Malik R, Hardikar W. Outpatient liver biopsy in children: safety, feasibility, and economic impact. J Pediatr Gastroenterol Nutr. 2017;65:86–88. - PubMed
    1. Gonzalez-Vallina R, Alonso EM, Rand E, Black DD, Whitington PF. Outpatient percutaneous liver biopsy in children. J Pediatr Gastroenterol Nutr. 1993;17:370–375. - PubMed
    1. Weigand K, Weigand K. Percutaneous liver biopsy: retrospective study over 15 years comparing 287 inpatients with 428 outpatients. J Gastroenterol Hepatol. 2009;24:792–799. - PubMed