Incidence of Complications from Percutaneous Biopsy in Chronic Liver Disease: A Systematic Review and Meta-Analysis

Helena B. Thomaides-Brears, Naim Alkhouri, Daniela Allende, Mukesh Harisinghani, Mazen Noureddin, Nancy S. Reau, Marika French, Carlos Pantoja, Sofia Mouchti, Donna R.H. Cryer

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


Background: Approaches to liver biopsy have changed over the past decade in patients with chronic liver disease. Aims: We conducted a systematic review and meta-analysis on the incidence of all complications and technical failure associated with percutaneous liver biopsy. Methods: We systematically searched PubMed and the Cochrane Library for cohort studies reporting on complications resulting from liver biopsy published between 2010 and 2020. Studies on participants of any age and sex, who underwent any percutaneous biopsy for non-focal liver disease, were selected. All events except mild pain, minor hematoma, vasovagal episodes, fever and fistula were defined as major complications. Random-effect model meta-analyses with and without covariates were performed, to examine the effect of publication year, patient characteristics, outcome collection, and biopsy type on incidences. Results: We identified 30 studies reporting on complications resulting from percutaneous liver biopsy procedures (n = 64,356). Incidence of major complications was 2.44% (95% CI 0.85, 6.75), with mortality at 0.01% (95% CI 0.00, 0.11), hospitalization at 0.65% (95% CI 0.38, 1.11), major bleeding at 0.48% (95% CI 0.22, 1.06), and moderate/severe pain at 0.34% (95% CI 0.08, 1.37). Minor complications at 9.53% (95% CI 3.68, 22.5) were mainly pain at 12.9% (95% CI 5.34, 27.9). Technical failure was high at 0.91% (95% CI 0.27, 3.00). Decreasing patient age significantly increased incidence of hospitalization and major bleeding (P < 0.0001). Hospitalization incidence also significantly increased with disease severity. Conclusions: Incidence of major (2.4%) and minor (9.5%) complications, and technical failure (0.91%) in percutaneous liver biopsies continues.

Original languageEnglish (US)
Pages (from-to)3366-3394
Number of pages29
JournalDigestive Diseases and Sciences
Issue number7
StatePublished - Jul 2022


  • Bleeding
  • Hospitalization
  • Pain
  • Percutaneous liver biopsy

ASJC Scopus subject areas

  • Physiology
  • Gastroenterology


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