Transjugular Liver Biopsy ‐ an Australian Experience

Abstract

During the four year period 1983-87 transjugular liver biopsy was performed on 67 patients (M43, F24) aged 17-79 yr (mean 45.6 yr). Standard percutaneous biopsy was contraindicated by coagulation disorders (95%) often with ascites (17%). Biopsies were taken using a specially modified Ross trans-septal needle passed into hepatic veins under fluoroscopic guidance. Hepatic tissue samples were obtained from the initial biopsy in 62 (93%) patients. In 30 consecutive transjugular biopsies a mean area of 38.2 mm2 per section (0.9-100 mm2) was available for histology compared with an area of 15.9 mm2 (9.3-48.8 mm2) in 50 consecutive percutaneous biopsies. Improved techniques of sample washing, sieving and fixation optimised separation of hepatic tissue from blood clot and fibrin. Four patients experienced significant complications but no deaths occurred. Individual diagnoses were changed in 17 patients as a result of biopsy findings. This study confirms the efficacy and relative safety of the transjugular approach in obtaining liver biopsies from patients with contraindications to standard percutaneous techniques.

Transjugular liver biopsy: histological diagnosis success comparing the trucut to the modified aspiration Ross needle

“…As stated by ZWIEBEL et al (30) , discordance may result from the application of different criteria to define complications. Also, the rate of complications may be associated with the experience of the professional performing the procedure (29) . Finally, the clinical status of patients submitted to TJLB is usually worse than that of patients submitted to other forms of biopsy (7,21,23) ; this may have an impact on the incidence of complications.…”

Major complications due to transjugular liver biopsy: Incidence, management and outcome

“…In most reported studies, probably because of a limited number of patients, there were no cases of intraperitoneal hemorrhage due to TJLB [13][14][15][19][20][21]. To date, a few studies have specifically placed a special emphasis on this severe complication but the majority of them did not provide details regarding management [2,22,23].…”

Transfemoral liver biopsy by forceps: A review of 104 consecutive procedures

“…In these patients the procedure has proved to be safe with low morbidity and mortality [1][2][3][4][5][6][7][8][9][10][11][12][13], although the diagnostic yield at 80-95% is lower than that of percutaneous liver biopsy [5,9] and can be as low as 64% in cirrhotic patients [6]. Despite the advantages of the transjugular route, it has not enjoyed widespread use, perhaps due to the expertise required to puncture the jugular veins and potentially serious complications as listed in Table 1 [5,6,9,11,13].…”