title: A comparison of transjugular and plugged-percutaneous liver biopsy in patients with contraindications to ordinary percutaneous liver biopsy and an "in-house" protocol for selecting the procedure of choice.
abstract: The purpose of this study was to evaluate the effectiveness and safety of transjugular liver biopsy (TJLB) and plugged-percutaneous liver biopsy (PB) in consecutive patients with severe liver disease associated with impaired coagulation, ascites, or both and to verify the in-house protocol used to select the appropriate procedure. In 2000-2006, 329 patients (208 male [62.8%] and 121 female [37.2%]), aged 1 month to 81 years (mean, 46.8 years), underwent 150 TJLBs (39.1%) or 233 PBs (60.9%) procedures at a major tertiary center, as determined by an in-house protocol. The groups were compared for specimen characteristics, technical success, and complications. Technical success rates were 97.4% for TJLB (146/150) and 99.1% for PB (231/233). TJLB was associated with a lower average core length (1.29 vs. 1.43 cm) and lower average number of specimens obtained (2.44 vs. 2.8), but both methods yielded sufficient tissue for a definitive diagnosis. There were no major complications in either group. TJLB and PB can be safely and effectively performed for the diagnosis of hepatic disease in patients with contraindications for standard percutaneous liver biopsy. When both are technically available, we suggest PB as the procedure of choice, especially in transplanted livers.
authors.affiliation: Vascular and Interventional Units, Department of Diagnostic Radiology, Hasharon Hospital, Petach Tikva, Israel. Atareli@hotmail.com
authors.forename: Eli
authors.initials: E
authors.lastname: Atar
authors.forename: Ziv
authors.initials: Z
authors.lastname: Ben Ari
authors.forename: Gil N
authors.initials: GN
authors.lastname: Bachar
authors.forename: Yelena
authors.initials: Y
authors.lastname: Amlinski
authors.forename: Chaim
authors.initials: C
authors.lastname: Neyman
authors.forename: Michael
authors.initials: M
authors.lastname: Knizhnik
authors.forename: Sergey
authors.initials: S
authors.lastname: Litvin
authors.forename: Hemda
authors.initials: H
authors.lastname: Schmilovitz-Weiss
authors.forename: Riki
authors.initials: R
authors.lastname: Shapiro
authors.forename: Elchanan
authors.initials: E
authors.lastname: Bruckhaimer
authors.forename: Ran
authors.initials: R
authors.lastname: Tur-Kaspa
authors.forename: Alexander
authors.initials: A
authors.lastname: Belenky
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000379:methods*; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D000075202:Contraindications; D005260:Female; D006801:Humans; D007223:Infant; D007601:Jugular Veins; D008107:Liver Diseases / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011183:Postoperative Complications; D015641:Radiography, Interventional; D012189:Retrospective Studies