Safety of percutaneous versus transjugular liver biopsy: A propensity score matched analysis

Lavian, Joshua D.; Thornton, L.; Zybulewski, Adam; Kim, E.; Nowakowski, S.F.; Ranade, M.; Patel, Rahul; Lookstein, R.; Fischman, A.; Bishay, V.

doi:10.1016/j.ejrad.2020.109399

Cited by 15 publications

(12 citation statements)

References 14 publications

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“…In conclusion, the study by Lavian et al [1] further extends the evidence on the excellent safety of TJLB with advantages over PCLB in patients with ascites, obesity and coagulopathy. Combining TJLB with HVPG measurement additionally amplifies the diagnostic utility of this…”

Section: Dear Editorsupporting

confidence: 55%

“…We read with great interest the recently published well-powered retrospective study by Lavian et al [1] addressing the safety of percutaneous liver biopsy (PCLB) versus transjugular liver biopsy (TJLB). They performed a propensity-matched (2:1) comparison of 978 patients undergoing PCLB versus 489 patients undergoing TJLB, respectively, correcting for liver-related comorbidities such as coagulopathy, thrombocytopenia, ascites, acute liver failure (ALF), cirrhosis and chronic hepatitis based on medical diagnosis codes.…”

Section: Dear Editormentioning

confidence: 99%

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Letter to Lavian and colleagues

Semmler

Reiberger

2021

European Journal of Radiology

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Section: Dear Editorsupporting

confidence: 55%

Section: Dear Editormentioning

confidence: 99%

Letter to Lavian and colleagues

Semmler

Reiberger

2021

European Journal of Radiology

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“…However, even in high-volume centers, PC-LB might determine a non-negligible sampling error rate, thus decreasing diagnostic sensitivity of the procedure; furthermore, as usually only the right lobe is accessible for biopsy, focal lesions located in the left lobe could be less easily sampled. Conversely, TJ-LB represents a more complex procedure and potential complications are neck hematoma, vascular injury, arterio-venous fistula, and intra-abdominal hemorrhage [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Yield of Endoscopic Ultrasound-Guided Liver Biopsy in Comparison to Percutaneous Liver Biopsy: A Two-Center Experience

Facciorusso

Ramai

Bellocchi³

et al. 2021

Cancers

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There is scarce and conflicting evidence on the comparison between endoscopic ultrasound (EUS) and percutaneous (PC)-guided liver biopsy (LB). The aim of this study was to compare the two approaches in a series of patients with parenchymal and focal liver lesions. Fifty-four patients undergoing EUS-LB in two high-volume centers between 2017 and 2021 were compared to 62 patients who underwent PC-LB. The primary outcome was diagnostic adequacy rate. The secondary outcomes were diagnostic accuracy, total sample length (TSL), number of complete portal tracts (CPTs), procedural duration, and adverse events. Variables were compared using the Chi-square and Mann–Whitney test. Median age was 56 years (interquartile range 48–69) in the EUS-LB group and 54 years (45–67) in the PC-LB group with most patients being male. Indication for LB was due to parenchymal disease in 50% of patients, whereas the other patients underwent LB due to focal liver lesions. Diagnostic adequacy was 100% in PC-LB and 94.4% in the EUS-LB group (p = 0.74), whereas diagnostic accuracy was 88.8% in the EUS-LB group and 100% in the PC-LB group (p = 0.82). Median TSL was significantly greater in the PC-LB group (27.4 mm, IQR 21–29) when compared to the EUS-LB group (18.5 mm, 10.1–22.4; p = 0.02). The number of complete portal tracts was 21 (11–24) in the PC-LB group and 18.5 (10–23.2) in EUS-LB group (p = 0.09). EUS-LB was a significantly longer procedure (7 min, 5–11 versus 1 min, 1–3 of PC-LB; p < 0.001) and no evidence of adverse events was observed in any of the study groups. These results were confirmed in the subgroup analysis performed according to an indication for LB (parenchymal disease versus focal lesion). Although PC-LB yielded specimens with greater TSL, diagnostic adequacy and accuracy were similar between the two procedures.

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“…Liver biopsies have been attempted through various techniques, including blind PLB, ultrasound-and CTguided PLB, and open PLB [8][9][10]. TJLB is recognized as an alternative biopsy technique to obtain tissue samples [11][12][13][14][15] that can be used in patients with contraindications for PLB, such as those with ascites or a tendency for bleeding. In 1964, Dotter [16] reported the use of TJLB in dogs.…”

Section: Discussionmentioning

confidence: 99%

Clinical Usefulness of Transjugular Liver Biopsy in Patients With Hematological Diseases With Liver Dysfunction

Ishikawa¹,

Kodama²,

Kobayashi³

et al. 2021

Cureus

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Introduction Transjugular liver biopsy (TJLB) is indicated for patients in whom percutaneous liver biopsy is contraindicated, such as those with hematological diseases complicated by liver dysfunction. However, the clinical utility of TJLB in this group of patients has not been thoroughly investigated. The objective of this study is to evaluate the clinical efficacy of TJLB in patients with hematological diseases complicated by liver dysfunction. Methods We analyzed the data of patients who developed liver disorders during treatment for hematological diseases at our hospital and required tissue diagnosis via TJLB. The clinical features of patients were analyzed. Results Twenty-seven patients (mean age, 60.07 years; 12 men, 15 women) requiring tissue diagnoses via TJLB after developing liver disorders while undergoing treatment for hematological diseases were enrolled. One patient with autoimmune hemolytic anemia was diagnosed with drug-induced liver injury; two patients with amyloidosis had nonalcoholic steatohepatitis; one patient with acute promyelocytic leukemia had a drug-induced liver injury; one patient with chronic myelomonocytic leukemia had liver infiltration caused by an underlying disease; three patients with idiopathic thrombocytopenic purpura had autoimmune hepatitis; four patients with malignant lymphoma had liver infiltration by the underlying disease, and one patient with multiple myeloma had liver disorder caused by disseminated intravascular coagulation. Moreover, one patient had hepatitis B reactivation, another had hepatitis E, and six patients had a drug-induced liver injury. The treatment regimen was altered in cases of liver infiltration caused by the underlying disease, and the drug was changed for patients with drug-induced liver injury. Conclusion The etiology of liver disorders in patients with hematological diseases varies widely. Therefore, histological diagnosis using TJLB is useful to determine an appropriate therapeutic strategy for underlying hematological diseases.

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Safety of percutaneous versus transjugular liver biopsy: A propensity score matched analysis

Cited by 15 publications

References 14 publications

Letter to Lavian and colleagues

Letter to Lavian and colleagues

Diagnostic Yield of Endoscopic Ultrasound-Guided Liver Biopsy in Comparison to Percutaneous Liver Biopsy: A Two-Center Experience

Clinical Usefulness of Transjugular Liver Biopsy in Patients With Hematological Diseases With Liver Dysfunction

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