Abdominal mass biopsy: Liver, Kidney, retroperitoneum, pelvis

PREOP EVALUATION

• All patients should be offered a clinic appointment if the patients wants.
• Review of prior imaging studies by one IR physician is essential before making a procedural appointment.  Can be in ECH or PAMF PACS or outside disc.  Best to upload outside studies into PAMF PACS (iSite) if there is time.

TIMING / BED REST AFTER PROCEDURE

• All cases should be done in the Morning.
• Renal biopsy should be first case in am and may need overnight observation
• Liver biopsy and most other biopsy procedures usually outpatient and scheduled ONLY in the morning

ANTICOAGULATION/ANTIPLATELETS

• Aspirin or Plavix- Stop 7 days before biopsy
• Lovenox, Low Molecular Weight Heparin (LMWH), Arixtra – Stop 24h prior to procedure
• Pradaxa – stop 3 days prior to procedure if possible.  See “Warfarin” immediately below for “bridge” anticoagulation, if necessary (CONTACT IR physician if uncertain)
• Warfarin (Coumadin) – Depends upon procedure and indication, as well as the reason the patient is taking this medication (CONTACT IR physician or PA)

LOCATION OF THE PROCEDURE

• Medical (nontargeted) liver or renal biopsies are done on US
• Retroperitoneal biopsies: CT
• Liver mass, pelvic or other biopsies - ask IR physicia

PREOPERATIVE ORDERS

• IV with NS (Normal Saline) 75ml/hr
• Labs:  CBC, PT/INR, PTT, Chem basic

FOLLOW UP

• Call 1-2 days after procedure.
• No further follow up required. 

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