Preoperativna priprema za biopsiju jetre
Feb 22, 2022
1. Edukacija pacijenata i informirani pristanak
The patient needs to be adequately prepared before a liver biopsy is performed. Ideally, patient education should begin at the preoperative clinic. The medical staff should explain the surgical procedure in detail to the patient, and pay attention to the treatment of the patient's anxiety and pain.
On the day of biopsy, the recent patient's prothrombin time (PT) and complete blood count (CBC) test results were comprehensively evaluated. The surgical procedure was explained to the patients and their informed consent was obtained.
2. Preoperativno planiranje
Aspirin je prekinut nedelju dana pre operacije. Nesteroidne antiinflamatorne lijekove (NSAID) treba prekinuti 3 dana prije biopsije. Od pacijenata se tražilo ili nije bilo traženo da poste preko noći. Prehrana prije operacije može smanjiti žučnu kesu, smanjujući rizik od probijanja žučne kese. Međutim, post može smanjiti vjerojatnost mučnine i povraćanja nakon operacije.
Američko gastroenterološko udruženje (AGA) preporučuje 1:
➤ Liver puncture should be completed within 30 minutes
➤ The patient needs to be escorted during the first night after surgery
➤ Patients should not have any contraindications or conditions that increase the risk associated with surgery (eg, severe complications such as encephalopathy, ascites, severe jaundiced liver failure, significant extrahepatic obstruction, major coagulopathy, or severe congestive heart failure)
➤ The facility performing the biopsy should have a nationally accredited blood bank, laboratory, inpatient bed, and nursing staff who can supervise the patient for at least 6 hours postoperatively; however, the American Association for the Study of Liver Diseases (AASLD) recommends a routine observation period of 2- 4 hours2.
➤ If bleeding, bile leak, pneumothorax, or need for more than one dose of analgesic, hospitalization is recommended
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