title: Transjugular liver biopsy--experience in fifty patients.
abstract: OBJECTIVE
  We evaluated the safety, adequacy, clinical impact and cost of transjugular liver biopsies performed at our institution.
  
  
  METHODS
  Eighty-four biopsies performed in 50 consecutive patients with coagulopathy (INR >1.4; n=20), thrombocytopenia (platelet count <75,000/cmm; n=17), ascites (n=10), or coagulopathy and thrombocytopenia (n=3) from April 1999 to July 2002 were analyzed. Biopsy was performed under local anesthesia with fluoroscopic guidance, using the Quick Core biopsy needle.
  
  
  RESULTS
  Ninety-two needle passes were made to obtain 84 samples. Biopsy was technically unsuccessful in two patients because of hepatic vein ostial block; however, the procedure established the diagnosis of blockage of hepatic vein ostia in these patients. Biopsy specimen was adequate for histological examination in 45 patients. The median number of biopsies performed with 18- and 19-gauge needles was 14 and 8, respectively. The biopsy provided diagnostic information in 23 of 50 (46%) patients, and helped in staging or providing prognostic information in 37 (74%) patients. There were no major complications. Minor complications included transient hepatic vein-to-portal vein fistula in 2, transient hepatic vein-biliary fistula in one, local hematoma in 5, and post-procedure fever in 5 patients. The approximate cost of the needle and accessories was Rs. 2000 per patient.
  
  
  CONCLUSIONS
  Transjugular liver biopsy was safe, provided adequate tissue in 90% of patients, and helped frequently in diagnosis and in staging or prognostication of disease.
authors.affiliation: Department of Gastroenterology, Bhatia General Hospital, Tardeo, Mumbai 400 007. nagral@vsnl.com
authors.forename: Aabha
authors.initials: A
authors.lastname: Nagral
authors.forename: Girish
authors.initials: G
authors.lastname: Waravdekar
authors.forename: Priya
authors.initials: P
authors.lastname: Nisar
authors.forename: Vimal
authors.initials: V
authors.lastname: Someshwar
authors.forename: Nishant
authors.initials: N
authors.lastname: Sadana
authors.forename: Mrudula
authors.initials: M
authors.lastname: Sampat
authors.forename: Keyuri
authors.initials: K
authors.lastname: Patel
mesh_terms: D000328:Adult; D001201:Ascites / Q000150:complications; D001707:Biopsy, Needle / Q000379:methods*; D001778:Blood Coagulation Disorders / Q000150:complications; D005260:Female; D006801:Humans; D007601:Jugular Veins; D008099:Liver / Q000473:pathology*; D008107:Liver Diseases / Q000150:complications / Q000473:pathology*; D008297:Male; D013921:Thrombocytopenia / Q000150:complications