Tolerance of liver biopsy in a tertiary care center:  comparison of the percutaneous and the transvenous route in 143 prospectively followed patients.
BACKGROUND
Transjugular liver biopsy (TJLB) is usually performed when a percutaneous liver biopsy (PLB) is contraindicated. TJLB is an invasive procedure and the patient's tolerance may be variable.


OBJECTIVE
To compare patient tolerance and quality of the biopsy sample between PLB and TJLB.


METHODS
A total of 143 patients underwent a liver biopsy; of these, 75 underwent TJLB and 68 underwent PLB. To evaluate patient tolerance, we used a visual analog scale that scored the intensity of the symptoms. The length of the biopsy sample and the total number of portal tracts per biopsy were also determined for assessment of biopsy quality.


RESULTS
The biopsy sample length was similar in both groups (18.88 ± 8.83 mm on PLB vs. 18.26 ± 10.30 mm on TJLB). No differences were found in the number of portal tracts between the two groups (10.43 ± 8.25 on TJLB vs. 12 ± 10.09 on PLB). Fewer complications were observed in the TJLB group compared with the PLB group (P=0.002).Further, higher degree of pain was reported by patients who underwent PLB compared with patients who underwent TJLB (3.18 ± 3.17 vs. 1.19 ± 2.07); as such, there was a greater need for analgesics on PLB.


CONCLUSIONS
TJLB and PLB techniques provide similar quality of tissue samples; however, TJLB is less painful and therefore better tolerated by patients.
Department of Hepato-gastroenterology, Purpan Hospital, CHU Toulouse, Toulouse, France. bogdanprocopet@gmail.com
Bogdan
B
Procopet
Christophe
C
Bureau
Sophie
S
Métivier
Janick
J
Selves
Marie Angèle
MA
Robic
Camille
C
Christol
Mircea
M
Grigorescu
Jean-Pierre
JP
Vinel
Jean-Marie
JM
Péron
D000328:Adult; D001706:Biopsy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology*; D008107:Liver Diseases / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D017060:Patient Satisfaction; D011168:Portal System / Q000473:pathology; D011446:Prospective Studies; D062606:Tertiary Care Centers