Percutaneous Liver Biopsy in Infants: A Single Center Experience

Background: Percutaneous liver biopsy (PLB) is a procedure extensively used for diagnosis or treatment assessment of hepatic disease in childhood.The purpose of this study was to evaluate the safety and effectiveness of US-guided PLB in infancy.Methods: Retrospective analysis of PLB performed in infants between January 2011 and December 2015 was conducted.All procedures were performed in inpatient infants, under general anaesthesia and US-guidance, with a disposable 16G x 90mm automated needle.The incidence of complications was evaluated.Postoperative coagulation studies were compared to preoperative ones.Results: Twenty-four infants (62% males; mean age: 89 days; mean weight: 5.7 kg) underwent US-guided PLB.One biopsy for each patient was performed (mean number of passes: 1.7; mean number of samples: 1.2; biopsy core mean length: 1 cm).The subcostal approach was preferred in 21 cases (87%), the intercostal in 3 (13%).Differential diagnosis included: biliary atresia (42%); glycogen storage disease (21%); total parenteral nutrition (TPN) cholestasis (12%); neonatal hepatitis (9%); follow-up for neonatal hemochromatosis post-chelation therapy 4%.In 3 patients (12%) a hepatic disease was excluded.None of the patients had minor or major complications.No deaths occurred.All biopsies provided enough liver for analysis.None of the infants had a biopsy repeated because of insufficient tissue.Conclusion: US-PLB in infants is a simple, safe and effective diagnostic tool.Experienced physicians are advocated.