Effect of operator experience and frequency of procedure performance on complication rate after ultrasound-guided percutaneous liver biopsies

J Pediatr Gastroenterol Nutr. 2013 Nov;57(5):638-43. doi: 10.1097/MPG.0b013e3182a0c7a5.

Abstract

Objective: The aim of the present study was to assess whether the complication rate after ultrasound-guided percutaneous liver biopsies in children is affected by how frequently the procedure is performed by the operator.

Methods: Medical charts and ultrasound descriptions of 311 ultrasound-guided percutaneous liver biopsy procedures performed by 18 radiologists at a single center from 2000 to 2011 were reviewed. Postbiopsy ultrasound the following day was performed after 97% of the procedures.

Results: There were no differences in the procedure-associated rate of major bleeding incidents (2.2% vs 0.8%, P = 0.38), minor bleeding incidents (15.2% vs 10.2%, P = 0.31), or abdominal pain (13.0% vs 10.6%, P = 0.61) among operators who performed ≤10 procedures and those who performed >10 procedures during the study period. A higher rate of minor bleeding incidents were recorded after liver biopsy when operators had performed <10 biopsies compared with operators who had performed >20 pediatric liver biopsies during the study period (odds ratio 3.4 [1.3-9.1], P = 0.02). No association between the number of biopsies performed by the operator during the 2 years preceding the date of the biopsy and complications was found.

Conclusions: Major complications are infrequent after pediatric liver biopsies and no relation between operator experience and major complications was found. We found a significant, but minor, effect of operator procedure frequency on the rate of minor bleeding incidents after ultrasound-guided pediatric liver biopsies.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdominal Pain / epidemiology
  • Abdominal Pain / prevention & control
  • Adolescent
  • Biopsy, Needle / adverse effects*
  • Child
  • Child, Preschool
  • Clinical Competence*
  • Endoscopy, Digestive System / adverse effects*
  • Hospitals, University
  • Humans
  • Image-Guided Biopsy / adverse effects*
  • Incidence
  • Infant
  • Liver / diagnostic imaging
  • Liver / pathology*
  • Liver Transplantation / adverse effects
  • Norway / epidemiology
  • Pain, Postoperative / epidemiology
  • Pain, Postoperative / prevention & control
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / epidemiology
  • Postoperative Complications / physiopathology
  • Postoperative Complications / prevention & control*
  • Postoperative Hemorrhage / diagnostic imaging
  • Postoperative Hemorrhage / epidemiology
  • Postoperative Hemorrhage / physiopathology
  • Postoperative Hemorrhage / prevention & control
  • Radiology, Interventional*
  • Retrospective Studies
  • Severity of Illness Index
  • Time Factors
  • Ultrasonography
  • Workforce