title: Clinical relevance of transjugular liver biopsy in comparison with percutaneous and laparoscopic liver biopsy.
abstract: BACKGROUND
  Transjugular liver biopsy (TJLB) is frequently used to obtain liver specimens in high-risk patients. However, TJLB sample size possibly limits their clinical relevance.
  
  
  METHODS
  102 patients that underwent TJLB were included. Clinical parameters and outcome of TJLB were analyzed. Control samples consisted of 112 minilaparoscopic liver biopsies (mLLBs) and 100 percutaneous liver biopsies (PLBs).
  
  
  RESULTS
  Fewer portal tracts were detected in TJLB (4.3 +/- 0.3) in comparison with PLB (11.7 +/- 0.5) and mLLB (11.0 +/- 0.6). No difference regarding the specification of indeterminate liver disease and staging/grading of chronic hepatitis was observed. In acute liver failure (n = 32), a proportion of hepatocellular necrosis beyond 25% was associated with a higher rate of death or liver transplantation.
  
  
  CONCLUSIONS
  Despite smaller biopsy samples the impact on the clinical decision process was found to be comparable to PLB and mLLB. TJLB represents a helpful tool to determine hepatocellular necrosis rates in patients with acute liver failure.
authors.affiliation: Department of Gastroenterology, Hepatology and Endocrinology, Medical School Hannover, Carl Neuberg Strasse 1, 30625 Hannover, Germany.
authors.forename: Max G
authors.initials: MG
authors.lastname: Beckmann
authors.forename: Matthias J
authors.initials: MJ
authors.lastname: Bahr
authors.forename: Johannes
authors.initials: J
authors.lastname: Hadem
authors.forename: Martin
authors.initials: M
authors.lastname: Bredt
authors.forename: Heiner
authors.initials: H
authors.lastname: Wedemeyer
authors.forename: Andrea S
authors.initials: AS
authors.lastname: Schneider
authors.forename: Stefan
authors.initials: S
authors.lastname: Kubicka
authors.forename: Michael P
authors.initials: MP
authors.lastname: Manns
authors.forename: Christian P
authors.initials: CP
authors.lastname: Strassburg
authors.forename: Jochen
authors.initials: J
authors.lastname: Wedemeyer