Volume 63, Issue 6 pp. e147-e151
Original Article: Hepatology

Ultrasound-Guided Liver Biopsy With Gelatin Sponge Pledget Tract Embolization in Infants Weighing Less Than 10 kg

Matthew P. Lungren

Corresponding Author

Matthew P. Lungren

Lucile Packard Children's Hospital, Stanford University, Stanford, CA

Address correspondence and reprint requests to Matthew P. Lungren, MD, MPH, Assistant Professor of Radiology, Department of Radiology, Stanford University School of Medicine, Stanford University Medical Center, 725 Welch Rd Room 1675, Stanford, CA 94305-5913 (e-mail: [email protected]).Search for more papers by this author
Will S. Lindquester

Will S. Lindquester

Children's Healthcare of Atlanta Emory University School of Medicine, Atlanta, GA

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Frank Glen Seidel

Frank Glen Seidel

Lucile Packard Children's Hospital, Stanford University, Stanford, CA

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Nishita Kothary

Nishita Kothary

Lucile Packard Children's Hospital, Stanford University, Stanford, CA

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Eric J. Monroe

Eric J. Monroe

Seattle Children's Hospital University of Washington, Seattle, WA

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Giri Shivaram

Giri Shivaram

Seattle Children's Hospital University of Washington, Seattle, WA

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Anne E. Gill

Anne E. Gill

Children's Healthcare of Atlanta Emory University School of Medicine, Atlanta, GA

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Matthew C. Hawkins

Matthew C. Hawkins

Children's Healthcare of Atlanta Emory University School of Medicine, Atlanta, GA

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First published: 01 December 2016
Citations: 20

The authors report no conflicts of interest.

ABSTRACT

Objectives:

The aim of the study was to describe and assess the technical success and safety of ultrasound-guided liver biopsy with gelatin sponge pledget tract embolization technique in infants <10 kg across 3 tertiary pediatric hospitals.

Materials and Methods:

There were 67 pediatric patients weighing <10 kg (36 boys; 31 girls; average age 202 days; average weight 6 kg, range 1.5–9.9 kg) referred for liver biopsy performed with ultrasound guidance and gelatin sponge pledget tract embolization during a 2-year period. Patient history, procedural records, and clinical follow-up documents were retrospectively reviewed.

Results:

A total of 67 procedures were included. There was 100% technical success rate and all samples obtained provided adequate tissue for histological assessment. Average number of 18 G biopsy passes was 3 (range 1–6). There were no procedure-related deaths. There was 1 complication (1%) in a 5-kg infant who was readmitted 36 hours after biopsy with a fever and fully recovered after antibiotics were administered. Biliary atresia was the most common underlying diagnosis (20%), whereas others included acute rejection (16%) and biliary obstruction (7%).

Conclusions:

Ultrasound-guided percutaneous liver biopsy with gelatin sponge pledget tract embolization technique in children weighing <10 kg is safe, effective, and use of this technique may lead to a reduction in rates of adverse events reported in other pediatric series.

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