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The utility of ultrasound guidance in transjugular liver biopsy: our experience

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Abstract

Purpose

To demonstrate the utility of ultrasound (US) guidance in improving the safety and efficacy of transjugular liver biopsy (TJLB) by analyzing all the TJLBs performed by us in the last 4 years.

Materials and methods

Forty-seven patients who underwent TJLB in the last 4 years in our two centers were retrospectively analyzed. US guidance was used for all but for one patient during the two crucial steps of the procedure—for internal jugular vein (IJV) access and during the parenchymal biopsy. Biopsies were obtained under real-time sonographic guidance from the right lobe after confirming an adequate room for needle throw without breaching the liver capsule or any major hilar structures. Post-procedure complications, tissue yield, and histopathological adequacy of samples were analyzed.

Results

Overall technical success rate was 100%. No major complications were found where ultrasound-assisted TJLB (uTJLB) was performed. One patient who underwent non-US guided TJLB had an event of a capsular breach and intra-peritoneal hemorrhage requiring coil embolization. Samples were of adequate dimension. Histopathological positivity was 100%. The overall complication rate for uTJLB was 4.7% which was due to minor complications in two patients.

Conclusions

Addition of US unit to the angiographic suite is effortless and Interventional Radiologists being already skilled in US can easily implement this simple yet valuable modification to conventional TJLB procedures. Our experience on uTJLB further emphasizes the role of US guidance in improving the procedural success rate, safety profile, and efficacy in the histopathological outcome of TJLB in all patients irrespective of age and disease burden.

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References

  1. Dotter CT (1964) Catheter biopsy: experimental technique for transvenous liver biopsy. Radiology. 82(2):312–314

    Article  PubMed  CAS  Google Scholar 

  2. Kaye R, Sane SS, Towbin RB (2000) Pediatric intervention: an update–part II. J Vasc Interv Radiol JVIR. 11(7):807–822

    Article  PubMed  CAS  Google Scholar 

  3. Bruzzi JF, O’Connell MJ, Thakore H, et al. (2002) Transjugular liver biopsy: assessment of safety and efficacy of the Quick-Core biopsy needle. Abdom Imaging. 27(6):711–715

    Article  PubMed  CAS  Google Scholar 

  4. Behrens G, Ferral H (2012) Transjugular liver biopsy. Semin Interv Radiol. 29(2):111–117

    Article  Google Scholar 

  5. Ble M, Procopet B, Miquel R, Hernandez-Gea V, García-Pagán JC (2014) Transjugular liver biopsy. Clin Liver Dis. 18(4):767–778

    Article  PubMed  Google Scholar 

  6. Bull HJ, Gilmore IT, Bradley RD, Marigold JH, Thompson RP (1983) Experience with transjugular liver biopsy. Gut. 24(11):1057–1060

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  7. Sacks D, McClenny TE, Cardella JF, Lewis CA (2003) Society of Interventional Radiology clinical practice guidelines. J Vasc Interv Radiol JVIR. 14(9 Pt 2):S199–S202

    Article  PubMed  Google Scholar 

  8. Kalambokis G, Manousou P, Vibhakorn S, et al. (2007) Transjugular liver biopsy–indications, adequacy, quality of specimens, and complications—a systematic review. J Hepatol. 47(2):284–294

    Article  PubMed  Google Scholar 

  9. Soyer P, Lacheheb D, Levesque M (1993) High-resolution sonographic guidance for transjugular liver biopsy. Abdom Imaging. 18(4):360–362

    Article  PubMed  CAS  Google Scholar 

  10. Mammen T, Keshava SN, Eapen CE, et al. (2008) Transjugular liver biopsy: a retrospective analysis of 601 cases. J Vasc Interv Radiol JVIR. 19(3):351–358

    Article  PubMed  Google Scholar 

  11. Lebrec D, Goldfarb G, Degott C, Rueff B, Benhamou JP (1982) Transvenous liver biopsy: an experience based on 1000 hepatic tissue samplings with this procedure. Gastroenterology. 83(2):338–340

    PubMed  CAS  Google Scholar 

  12. Smith TP, Presson TL, Heneghan MA, Ryan JM (2003) Transjugular biopsy of the liver in pediatric and adult patients using an 18-gauge automated core biopsy needle: a retrospective review of 410 consecutive procedures. Am J Roentgenol. 180(1):167–172

    Article  Google Scholar 

  13. Patel A, Gogna A, Irani FG, et al. (2014) Single centre experience of transjugular liver biopsy in 152 patients. Ann Acad Med Singapore. 43(3):160–165

    PubMed  Google Scholar 

  14. Cholongitas E, Quaglia A, Samonakis D, et al. (2006) Transjugular liver biopsy: how good is it for accurate histological interpretation? Gut 55(12):1789–1794

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  15. Livingstone RS, Keshava SN (2011) Technical note: reduction of radiation dose using ultrasound guidance during transjugular intrahepatic portosystemic shunt procedure. Indian J Radiol Imaging. 21(1):13–14

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

The authors would specially like to thank Mrs. Rama, IR nurse and Mrs. Kalpana, research analyst for the help during data collection.

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Authors and Affiliations

  1. Department of Interventional Radiology & Interventional Oncology, BGS Gleneagles Global Hospitals, Bangalore, India

    Bibin Sebastian, Soumil Singhal, Rohit Madhurkar & Mangerira Chinnappa Uthappa

  2. Department of Interventional Radiology, Gleneagles Global Hospitals, Chennai, India

    Sandeep Botcha & Thiruchunapalli Deepashree

Authors
  1. Bibin Sebastian
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  2. Soumil Singhal
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  3. Sandeep Botcha
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  4. Rohit Madhurkar
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  5. Thiruchunapalli Deepashree
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  6. Mangerira Chinnappa Uthappa
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Corresponding author

Correspondence to Bibin Sebastian.

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Sebastian, B., Singhal, S., Botcha, S. et al. The utility of ultrasound guidance in transjugular liver biopsy: our experience. Abdom Radiol 44, 749–755 (2019). https://doi.org/10.1007/s00261-018-1736-4

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  • DOI: https://doi.org/10.1007/s00261-018-1736-4

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