Year 2020 / Volume 112 / Number 12
Original
Percutaneous hepatic biopsy under propofol sedation. A safe and effective procedure

903-908

DOI: 10.17235/reed.2020.6942/2020

Javier Jiménez Sánchez, Lydia Serrano Díaz, Blanca Gallego Pérez, Carmen María Marín Bernabé, Daniel García Belmonte, María Gómez Lozano, Úrszula Gajownik, Juan José Martínez Crespo,

Abstract
Introduction: the percutaneous hepatic biopsy is a necessary procedure for the diagnosis of liver diseases which can cause complications and psychological discomfort for the patient. Aims: to determine the safety profile of propofol in percutaneous hepatic biopsy, the complications of the technique per se and patients satisfaction once completed. Methods: a retrospective observational study was performed via the acquisition of data of tolerance and perceived quality by the patients using a transversal survey. Results: ninety-seven patients were included with an average propofol dose of 170.46 mg. Of the complications resulting from the sedation, there were six slight desaturations (6.2 %) resolved with a forehead maneuver (50 %) or cessation of the propofol infusion pump (50 %) and eleven hypotension episodes (11.3 %) resolved without intervention (82.82 %) or with fluid replacement (18.18 %). Of the complications resulting from the technique, there were three cases of early-onset pain (3.1 %) and one delayed (1.03 %); all were resolved with 1 g of intravenous paracetamol. All patients were discharged with oral tolerance and without the need for analgesia 24 hours after the procedure. General satisfaction, as well as psychological discomfort, were evaluated as “very good/excellent” in 100 % of the patients. Discussion: propofol demonstrated a favorable safety profile in hepatic biopsy, aiding in the ultimate success of the procedure and tolerance for the patient. We propose the expansion of the use of sedation with propofol to this procedure.
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References
1. Martín Ramos L, Iruzubieta Coz P, Pons Romero F. Indicaciones y contraindicaciones de la biopsia hepática. Medicine 2012; 11: 620-3 –col. 11 núm 10.
2. Casado-Martín M, Carreño-González R and Lázaro-Sáez M. La biopsia hepática: indicaciones, técnica y complicaciones. 2009 Rapd Online vol. 32 Nº4. Julio-Agosto 2009.
3. Solís Herruzo JA. Indicaciones actuales de la biopsia hepática. Rev Esp Enferm Dig 2006, 98:122-129.
4. Rockey D, Cadwell S, Goodman Z et al. Liver biopsy. Hepatology 2009; 49:1017-1044.
5. Grant A, Neuberger J. Guidelines on the use of liver biopsy in clinical practice. Gut 1999; 45(suppl IV); IV 1-IV 11.
6. Gilmore IT, Burroughs A, Murray-Lyon IM, et al. Indicatios, methods, and outcomes of percutaneous liver biopsy in Englend and Wales: an audit by the British Society of gastroenterology and the Royal college of physicians of London. Gut 1995; 36,437-441.
7. Cadranel JF, Rufat P, Degos F. Practices of liver biopsy in France: results of a prospective nationwide survey. Hepatology 2000; 32:477-481.
8. Sorbi D, McGill DB, Thistle JL et al. An assessment of the role of liver biopsies in asyntomatic patients with chronic liver test abnormalities. Am J Gastroenterol 2000; 95:3206-3210.
9. Zarski JP, Sturm N, Guechot J, et al. Comparison of nine blood tests and transient elastography for liver fibrosis in chronic hepatitis C: the ANRS HCEP-23 study. J Hepatol 2012; 56:55.
10. Castéra L, Vergniol J, Foucher J, et al. Prospective comparison of transient elastography, Fibrotest, APRI, and liver biopsy for the assessment of fibrosis in chronic hepatitis C. Gastroenterology 2005; 128:343.
11. Gao Y, Zheng J, Liang P, et al. Liver Fibrosis with Two-dimensional US Shear-Wave Elastography in Participants with Chronic Hepatitis B: A Prospective Multicenter Study. Radiology 2018; 289:407.
12. Serra MA. Tratamiento de las complicaciones de la biopsia hepática. In Bruguera M, Miño G, Pons F, Moreno R, eds: Tratamiento de las enfermedades hepáticas. 1ª Edn. NILO Industria gráfica SA. 1997:307-312.
13. Boyum JH, Atwell Td, Schmit Gd, et al. Incidence and risk factors for adverse events related to image-guided liver biopsy. Mayo Clin Proc. 2016 Mar;91(3):329-35. doi: 10.1016/j.mayocp.2015.11.015. Epub 2016 Feb 2
14. Alexander JA, Smith BJ. Midazolam sedation for percutaneous liver biopsy. Digest Dis Sci 38, 2209–2211 (1993) doi:10.1007/BF01299897
15. Rex D, Deenadayalu VP, Eid E, et al. Endoscopist-directed administration of propofol: a worldwide safety experience. Gastroenterology 2009;137:1229-37. DOI: 10.1053/j.gastro.2009.06.042
16. Multisociety sedation curriculum for gastrointestinal endoscopy. Gastrointest Endoscoc 2012, 76: 1-25
17. Igea F, Casellas JA, González-Huix F et al. Sedación en endoscopia digestiva. Guía de práctica clínica de la Sociedad Española de Endoscopia Digestiva. Rev Esp Enferm Dig 2014;106:195-211
18. Vautier G, Scott B, Jenkins D. Liver biopsy: blind or guided? BMJ 1994; 309:1455-1456.
19. Lindor KD, Bru C, Jorgensen RA, et al. The role of ultrasonography and automatic-needle biopsy in outpatient percutaneous liver biopsy. Hepatology 1996; 23:1079-1083.
20. Farrell RJ, Smiddy PF, Pilkinton RM, et al. Guided versus blind liver biopsy for chronic hepatitis C: clinical benefits and costs. J Hepatol 1999; 30:580-587.
21. Tapper EB. and Lok AS. Use of liver imaging and biopsy in clinical practice. N. Engl. J. Med. 2017; 377, 756–768, https://doi.org/10.1056/NEJMra1610570
22. Martínez Crespo J, Martínez Guzmán M, et Pons Miñano JA. Infiltración anestésica local con mepivacaína y bicarbonato previo a la práctica de una biopsia hepática. Carta al director. Gastroenterol Hepatol. 1999 Jan;22(1):29-30.
23. Shaffer R, Mok ande Diehl D. The role of EUS in liver biopsy. Current Gastroenterology Reports (2019) 21: 6 https://doi.org/10.1007/s11894-019-0675-8
24. Campos S, Poley JW, Van Driel L, et al. The role of EUS in diagnosis and treatment of liver disorders. Endosc Int Open. 2019 Oct;7(10):E1262-E1275. doi: 10.1055/a-0958-2183. Epub 2019 Oct 1.
25. Rex D. Endoscopist-Directed Propofol. Gastrointest Endosc Clin N Am. Julio de 2016; 26 (3): 485-92. doi: 10.1016 / j.giec.2016.02.010.
26. Sieg A, Beck S, Scholl SG et al. Safety Safety analysis of endoscopist-directed propofol sedation: a prospective, national multicenter study of 24 441 patients in German outpatient practices. J Gastroenterol Hepatol. 2014 Mar;29(3):517-23
27. Daza JF, Tan CM, Fielding RJ et al. Propofol administration by endoscopists versus anesthesiologists in gastrointestinal endoscopy: a systematic review and meta-analysis of patient safety outcomes. Can J Surg. 2018 Aug;61(4):226-236.
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Jiménez Sánchez J, Serrano Díaz L, Gallego Pérez B, Marín Bernabé C, García Belmonte D, Gómez Lozano M, et all. Percutaneous hepatic biopsy under propofol sedation. A safe and effective procedure. 6942/2020


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Publication history

Received: 04/02/2020

Accepted: 10/04/2020

Online First: 29/10/2020

Published: 09/12/2020

Article revision time: 65 days

Article Online First time: 268 days

Article editing time: 309 days


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