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

Abstract

-Background -Transjugular liver biopsy is an alternative procedure for patients who present contraindications to standard percutaneous procedure. Aim -To compare the rate of histological diagnosis obtained on transjugular liver biopsy with an automated trucut needle and with a modified Ross needle. Patients/Methods -Eighty-five patients with suspicion of chronic liver diseases and presenting contraindications for percutaneous liver biopsy (coagulopathy, massive ascites, morbid obesity, or chronic renal problems) were submitted to 89 transjugular liver biopsies between March 1994 and April 2001 at "Hospital São José, Irmandade da Santa Casa de Misercórdia", Porto Alegre, RS, Brazil. Thirty-five patients underwent 36 biopsies with an automated trucut needle, and 50 patients underwent 53 biopsies with a modified Ross needle. Results -Histological diagnosis was reached in 32/35 subjects submitted to transjugular liver biopsy with the trucut needle (91%) and in 35/50 (70%) submitted to biopsy with the modified Ross needle. Specimens obtained with the trucut needle were significantly larger and less fragmented than those obtained with the Ross needle. Conclusion -Transjugular liver biopsy with the automated trucut needle allowed a higher rate of histological diagnosis when compared to the modified Ross needle in patients with suspicion of chronic liver diseases.

Transjugular liver biopsy – Indications, adequacy, quality of specimens, and complications – A systematic review

“…Longer and better diagnostic specimens were obtained using the Tru-Cut compared to Menghini needle, perhaps related to its reduced rate of fragmentation. Studies formally compar- ing Tru-Cut and Menghini TJLB needles [40,42,43,45] and our own analysis showed similar results. However, in two studies that compared the mean CPT number, it was significantly higher using the Tru-Cut needle [43,45].…”

“…In total, 60 studies (57 full papers and three abstracts) published between 1978 and 2006 met the inclusion criteria. Four studies [40,42,43,45] separately described and analyzed two different TJLB series (Menghini and Tru-Cut needle), which were considered separately giving a total of 64 series. Centers performing P100 TJLBs were considered more experienced and more recent publications (after 1996) as those encompassing longer experience (timerelated).…”

Safety and efficacy of sonographic‐guided random real‐time core needle biopsy of the liver

“…The rate of nondiagnostic specimens is slightly higher with percutaneous biopsies, with a successful biopsy rate of 91-98%. [12][13][14] Major complications are observed in 1-3% of the cases. 15 Laparoscopic liver biopsy is generally reserved for patients who are already undergoing surgery for other reasons.…”

A clinical scoring system for predicting nonalcoholic steatohepatitis in morbidly obese patients

“…Histologic analysis also provides unique prognostic information indicative of patients more likely to progress from NASH to cirrhosis 2, 19. However, liver biopsy is invasive, associated with complications, and physically challenging in those who are obese 20–23…”