Transjugular liver biopsy in the 1990s: a 2-year audit.
BACKGROUND
In view of the changing nature of transjugular liver biopsy, we performed an audit of the safety, adequacy and clinical impact of such biopsies in our centre over a 2-year period from 1995 to 1997.


METHODS
One hundred and fifty-seven transjugular biopsies were carried out in 145 patients, with prothrombin time >5 s over control and/or platelet count <50 x 10(9)/L and/or gross ascites.


RESULTS
Major complications were two (1.3%) capsular perforations, which were easily plugged with coils without sequelae. Biopsy sample was adequate for histological diagnosis in 90%, inadequate in 6% and technically unsuccessful in 4% of cases. Mean biopsy size was 14.8+/-7.7 (1-51) mm. Adequacy did not differ between cases with and without cirrhosis. Transjugular biopsy had a clinical impact (specific diagnosis or influence on patient's management) in 50% of acute liver disease, 62% of chronic liver disease and 87% of transplant patients (P<0.001). In chronic liver disease, it had a significantly greater clinical impact in cases trying to establish the stage rather than diagnosis (84% vs. 35%, P<0.001).


CONCLUSIONS
Transjugular liver biopsy is a safe procedure for high-risk patients providing an adequate liver sample even in cirrhosis. It has a clinical impact in more than 80% of transplant patients and for staging chronic liver disease, but in only 50% (acute) or 35% (chronic) of liver disease when a diagnosis is sought.
Papatheodoridis
G V
GV
Liver Transplantation and Hepatobiliary Medicine, London, UK.
Patch
D
D
Watkinson
A
A
Tibballs
J
J
Burroughs
A K
AK
D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy / Q000009:adverse effects / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007601:Jugular Veins; D008099:Liver / Q000473:pathology*; D008297:Male; D008485:Medical Audit; D008875:Middle Aged