Transjugular Approach to Liver Biopsy and Transhepatic Cholangiography

Rösch, Josef; Lakin, Paul C.; Antonovic, Ruza; Dotter, Charles T.

doi:10.1056/nejm197308022890501

Cited by 126 publications

(32 citation statements)

References 9 publications

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“…All percutaneous biopsies in this study were obtained with a Menghini needle, while the transjugular biopsies (12)(13)(14) were obtained as previously described (10). In the 19 patients with alcoholic liver disease, only one biopsy was performed by the transjugular route.…”

Section: Materials and Methods Human Studiesmentioning

confidence: 99%

Sinusoidal caliber in alcoholic and nonalcoholic liver disease: Diagnostic and pathogenic implications

et al. 1985

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Portal hypertension in alcoholic liver disease has been attributed to an increased resistance to blood flow either of sinusoidal or of postsinusoidal origin. The former should be accompanied by sinusoidal compression while the latter is expected to result in an increased or a normal sinusoidal diameter. Patients with alcoholic liver disease showed a marked reduction (p less than 0.001) in relative sinusoidal area (995 +/- 135 micron 2; n = 19) when compared to nonalcoholic patients with normal liver histology (5,100 +/- 389 micron 2; n = 6), or to patients with nonalcoholic liver disease (6,242 +/- 467 micron 2; n = 19). Hepatocyte surface area was significantly increased in patients with alcoholic liver disease when compared to hepatocytes from normal biopsies (563 +/- 32 micron 2 vs. 301 +/- 26 micron 2; p less than 0.001). Patients with nonalcoholic liver disease had hepatocyte surface areas within the normal range (327 +/- 14 micron 2). There was a significant inverse correlation between hepatocyte size and sinusoidal area (r = -0.63; p less than 10(-6); n = 44), indicating that larger hepatocytes were associated with sinusoidal compression. In the alcoholic patients, portal pressure correlated inversely (r = -0.77; p less than 0.01) with sinusoidal area only after the sinusoidal area was markedly reduced to areas below 20% of normal. Such a threshold was not reached in patients with nonalcoholic liver disease, in whom no correlation between sinusoidal area and portal pressure was observed.(ABSTRACT TRUNCATED AT 250 WORDS)

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Section: Materials and Methods Human Studiesmentioning

confidence: 99%

Sinusoidal caliber in alcoholic and nonalcoholic liver disease: Diagnostic and pathogenic implications

et al. 1985

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“…It was first described by Dotter in 1964(Dotter 1964) but the first major series was reported by Rosch et al in 1973(Rosch, Lakin, Antonovic andDotter 1973). The transvenous route was introduced as an alternative to the percutaneous route when there are concerns about coagulopathy or significant ascites and in those with morbid obesity (Rockey, et al 2009).…”

Section: Transvenous Liver Biopsymentioning

confidence: 99%

Complications of Liver Biopsy

Subar¹,

Khan²,

O’Reilly³

2011

Liver Biopsy

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“…Embolization of bleeding esophageal varices has been performed either by the percutaneous transhepatic route, 19 the transjugular transhepatic approach, 20 or via the umbilical veins. 21 Up to 36% of patients develop portal vein thromboses and postembolization ascites is a problem.…”

Section: Introductionmentioning

confidence: 99%

Sclerotheraphy for Esophageal Varices: A Retrospective Study of 61 Patients Treated at King Faisal Specialist Hospital

et al. 1984

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Over a period of 36 months, 61 patients underwent sclerotherapy for esophageal varices, 49 after a variceal bleeding episode (Group I) and 12 selected patients prophylactically (Group II). Mean follow-up was 12.6 months in Group I and 15.5 months in Group II. In Group I 27% died; only 10% of those patients presenting with mild liver disease (Child's Group A) who were followed died of gastrointestinal hemorrhage; but all presenting with severe liver disease (Child's Group C) died after a mean of 6.3 months, 57% following rebleeding. No patients in Group II died from esophageal hemorrhage. The rebleeding risk per patient-month of follow-up was 0.04 in Group I, 0.005 in Group II and 0.01 in the 22% of patients in Group I who achieved complete ablation of their varices. There was no mortality attributable to the procedure, and complications occurred after only 4.5% of the procedures; all were reversible. Sclerotherapy seems at present the treatment of choice for bleeding esophageal varices, considering its efficacy, safety and simplicity. It is probably also of value prophylactically in selected patients.

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Transjugular Approach to Liver Biopsy and Transhepatic Cholangiography

Cited by 126 publications

References 9 publications

Sinusoidal caliber in alcoholic and nonalcoholic liver disease: Diagnostic and pathogenic implications

Sinusoidal caliber in alcoholic and nonalcoholic liver disease: Diagnostic and pathogenic implications

Complications of Liver Biopsy

Sclerotheraphy for Esophageal Varices: A Retrospective Study of 61 Patients Treated at King Faisal Specialist Hospital

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