ABSTRACT
BACKGROUND. Histological evaluation has a crucial role in
diagnosing hepatic diseases and percutaneous liver biopsy (PLB) is
widely chosen for this purpose. We aim to describe its indications, the
rate and severity of adverse events (AEs) in an outpatient and
ultrasound (US)-guided setting over 5 years.
METHODS. This observational, single-center, and retrospective
study included patients submitted to PLB between 2015 and 2019. We
collected age, gender, coagulation tests, comorbidities, and number of
needle passes. The association between the variables and outcomes (pain,
mild and serious AEs, hospital admission, surgical treatment, and death)
was evaluated using the generalized estimating equations method.
RESULTS . We analyzed 532 biopsies in 524 patients (55.3% male)
aged 49y (13–74y). Almost 39% had cardiovascular comorbidities and
18% had overweight/obesity. Hepatitis C virus (HCV) chronic infection
was the major indication for PLB (47%), followed by autoimmune
hepatitis/cholestasis (12.6%), and metabolic dysfunction-associated
fatty liver disease (MAFLD) (12.1%). The number of HCV-related biopsies
had a remarkable reduction, while MAFLD-related procedures have
progressively raised over time. Around 54% of the patients reported
pain, which was significantly associated with the female gender
(p=0.0143). Serious AEs occurred in 11 patients (2.1%); hospital
admission was necessary in 10 cases (1.9%), but no patient required
surgical approach and there were no deaths. No significant association
was found between the occurrence of AEs and the studied variables
(clinical, laboratory, and number of needle passes).
CONCLUSION. Real-time US-guided PLB is safe to perform in an
outpatient setting and its indications have notably undergone a
transition from HCV to MAFLD over the years. New strategies to prevent
biopsy-related pain are still needed, especially for females.
KEYWORDS: Liver biopsy, Hepatitis C, Steatosis, Fatty liver
disease, Liver enzymes.