title: Major complications due to transjugular liver biopsy: Incidence, management and outcome.
abstract: OBJECTIVE
  The purpose of this study was to retrospectively evaluate the incidence of intraperitoneal bleeding and other major complications of transjugular liver biopsy (TJLB) and analyze their outcome and management.
  
  
  METHODS
  The clinical files of 341 consecutive patients who had TJLB were retrospectively analyzed. There were 237 men and 104 women (mean age: 51.38±12.8 years; range: 17-89 years). All patients had TJLB because standard percutaneous transhepatic biopsy was contraindicated. Patients' files were reviewed to search for major and minor procedure-related complications during or immediately after TJLB.
  
  
  RESULTS
  TJLBs were technically successful in 331/341 patients (97.07%; 95%CI: 94.67-98.58%). Major complications consisted exclusively of intraperitoneal bleeding due to liver capsule perforation and were observed in 2/341 patients (0.59%; 95%CI: 0.07-2.10%). They were treated using transcatheter arterial or venous embolization with a favorable outcome. The most frequent minor complications were abdominal pain (35/341; 10.26%; 95%CI: 7.25-13.99%) and supraventricular arrhythmia (15/341; 4.40%; 95%CI: 2.48-7.15%). No cases of inadvertent injury of the carotid artery were observed.
  
  
  CONCLUSIONS
  Major complications during TJLB are extremely rare and can be managed using arterial or venous embolization with a favorable outcome. Our results reinforce the general assumption that TJLB is a safe and well-tolerated technique.
authors.affiliation: Department of Abdominal Imaging, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France; Université Diderot-Paris 7, 10, avenue de Verdun, 75010 Paris, France. Electronic address: anthony.dohan@lrb.aphp.fr.
authors.forename: A
authors.initials: A
authors.lastname: Dohan
authors.affiliation: Department of Abdominal Imaging, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France. Electronic address: youcef.guerrache@lrb.aphp.fr.
authors.forename: Y
authors.initials: Y
authors.lastname: Guerrache
authors.affiliation: Department of Abdominal Imaging, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France; Université Diderot-Paris 7, 10, avenue de Verdun, 75010 Paris, France. Electronic address: raphael.dautry@lrb.aphp.fr.
authors.forename: R
authors.initials: R
authors.lastname: Dautry
authors.affiliation: Department of Abdominal Imaging, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France. Electronic address: mourad.boudiaf@lrb.aphp.fr.
authors.forename: M
authors.initials: M
authors.lastname: Boudiaf
authors.affiliation: Department of Abdominal Imaging, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France. Electronic address: Olivier.ledref@lrb.aphp.fr.
authors.forename: O
authors.initials: O
authors.lastname: Ledref
authors.affiliation: Department of Abdominal Imaging, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France; Université Diderot-Paris 7, 10, avenue de Verdun, 75010 Paris, France. Electronic address: marc.sirol@lrb.aphp.fr.
authors.forename: M
authors.initials: M
authors.lastname: Sirol
authors.affiliation: Department of Abdominal Imaging, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France; Université Diderot-Paris 7, 10, avenue de Verdun, 75010 Paris, France. Electronic address: philippe.soyer@lrb.aphp.fr.
authors.forename: P
authors.initials: P
authors.lastname: Soyer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000379:methods; D005260:Female; D006465:Hemoperitoneum / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D006801:Humans; D015994:Incidence; D007601:Jugular Veins; D008099:Liver / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D015641:Radiography, Interventional / Q000009:adverse effects*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Interventional radiology; Liver biopsy; Transjugular liver biopsy