Assessment of the Efficacy and Potential Complications of Transjugular Liver Biopsy in Canine Cadavers

Abstract

BackgroundTransjugular liver biopsy (TJLB) is used in humans at risk of bleeding. There are no reports of its use in veterinary medicine.ObjectiveTo assess the efficacy and potential complications of TJLB in canine cadavers, and compare with samples obtained via needle liver biopsy (NLB) and surgical liver biopsy (SLB).AnimalsTwenty‐five medium and large breed canine cadavers.MethodsProspective study. TJLBs were procured through the right jugular vein. After biopsy, intravenous contrast and gross inspection were used to assess the biopsy site. Minor and major complications were recorded. NLBs and SLBs were then obtained. Histopathology was performed, and TJLB and NLB were compared for number of complete portal tracts (CPTs), length, and fragmentation. Pathologic process and autolysis were assessed in all samples.ResultsAll TJLBs yielded liver tissue. The proportion of minor complications was 12/25 (48%), and major complications 16/25 (64%); 13/16 (81%) of the major complications were liver capsule perforation. In 21/25 (84%), the histopathology in the SLB was reflected in the TJLBs. For cases with minimal autolysis, median number of CPTs in TJLBs was 7.5, compared with 4 in NLBs (P = .018). Median length of TJLB specimen was 28 mm compared to 22 mm in NLBs (P = .007). Fragmentation rate was median of 1.25 for TJLB compared to 1.50 in NLBs (P = .11).Conclusions and Clinical Importance TJLB is technically feasible and achieves comparable results to NLB and SLB. The number of complications, in particular liver capsule perforation, was greater than expected. Further studies are indicated before clinical use is recommended.

Outcomes of cellophane banding or percutaneous transvenous coil embolization of canine intrahepatic portosystemic shunts

“…The liver was biopsied in all dogs in the CB group, and several dogs underwent concurrent cystotomy and ovariohysterectomy or ovariectomy. These procedures are not possible via the EJV, although transjugular liver biopsy may become a viable option in the future . Although repeat surgery may be a concern for some clients, several owners opted to have their dogs returned for laparoscopic ovariectomy and liver biopsy after PTCE.…”

Comparison of diagnostic accuracy of laparoscopic 3 mm and 5 mm cup biopsies to wedge biopsies of canine livers

“…Two liver lobes (each from a different hepatic division) were selected for sampling; if lesions were noted grossly, the biopsy was taken from this region to mimic clinical surgical goals and not to miss any lesions. 10 Each biopsy method (3 mm laparoscopic cup, 5 mm laparoscopic cup, and gold-standard necropsy wedge) was used for each lobe, yielding 2 replicates for each method and a total of 6 liver samples from each dog (Stryker, 5 mm monopolar handle with biopsy forceps [cup and pin], Kalamazoo, Michigan and Stryker, 3 mm monopolar handle with biopsy forceps [cup], Kalamazoo, Michigan). Two liver lobes were sampled because sampling 2 different liver lobes ensures a more accurate histologic diagnosis.…”

“…Post-mortem changes were attempted to be limited by using only fresh cadavers < 24 hours old and excluding any cases judged to have excessive autolysis by the participating boardcertified veterinary pathologist. However, early changes associated with autolysis might have obscured more subtle pathologic processes and the use of live animals might have yielded a higher number of portal tracts 10. Hematoxylin and eosin were the only stains used and special stains, especially stains for collagen (Trichrome Masson) and reticulin stains could have increased the accuracy of diagnosis.…”

Comparison of two minimally invasive techniques for liver biopsy collection in dogs

“…This study concluded that needle biopsy specimens of the liver of dogs and cats must be interpreted with caution (Cole et al 2002 ). Transjugular liver biopsy is a technique commonly used in human patients, but only one cadaveric study has been published in dogs and a high complication rate was reported (Levien et al 2014 ).…”

“…Transjugular liver biopsy is a technique commonly used in human patients, but only one cadaveric study has been published in dogs and a high complication rate was reported (Levien et al . ).…”