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

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Abdominal Radiology Aims and scope Submit manuscript

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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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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