title: Transjugular liver biopsy in the 1990s: a 2-year audit.
abstract: 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.
authors.affiliation: Liver Transplantation and Hepatobiliary Medicine, London, UK.
authors.forename: G V
authors.initials: GV
authors.lastname: Papatheodoridis
authors.forename: D
authors.initials: D
authors.lastname: Patch
authors.forename: A
authors.initials: A
authors.lastname: Watkinson
authors.forename: J
authors.initials: J
authors.lastname: Tibballs
authors.forename: A K
authors.initials: AK
authors.lastname: Burroughs
mesh_terms: 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