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Utility and Safety of Transjugular Liver Biopsy in Children

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Abstract

Transjugular liver biopsy (TJLB) is widely used in adults when percutaneous liver biopsy (PLB) is contraindicated. The authors evaluated the safety, efficacy and utility of TJLB in pediatric patients with contraindications to PLB. Twenty-three children and adolescents (13 male) underwent 24 (one patient had two separate biopsies) consecutive biopsies (TJLB) under general anaesthesia (18) or intravenous sedation (6). PLB was contraindicated because of elevated prothrombin time (PT)/international normalized ratio (INR) (˃ 15.5/1.5) in 19 (79.2%) and thrombocytopenia (< 60,000/dL) in 15 (62.5%) procedures. Derangement in both INR and platelet count were found in 12 (50%) cases. Significant ascites was present in 10 (41.7%) procedures. Technical success rate with adequate biopsy sample was 95.8% (23/24) with no major complications. A new diagnosis was established in 9 (37.5%) cases. Another 14 (58.34%) biopsies confirmed the initial diagnoses. Four cases also revealed additional information guiding overall management and prognosis. Thus, TJLB is a safe and useful procedure in children.

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Authors and Affiliations

  1. Division of Gastroenterology, Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), New Delhi, India

    Prabir Maji & Rohan Malik

  2. Department of Radiology, All India Institute of Medical Sciences (AIIMS), New Delhi, India

    K. S. Madhusudhan & Sanjay Sharma

Authors
  1. Prabir Maji
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  2. Rohan Malik
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  3. K. S. Madhusudhan
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  4. Sanjay Sharma
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Contributions

PM and RM conceived the study. PM, RM and KSM wrote the manuscript. SS reviewed the manuscript and edited it. SS will act as guarantor for this paper.

Corresponding author

Correspondence to Rohan Malik.

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Cleared by the Institutional Ethics Committee, AIIMS, New Delhi.

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Maji, P., Malik, R., Madhusudhan, K.S. et al. Utility and Safety of Transjugular Liver Biopsy in Children. Indian J Pediatr 88, 709–711 (2021). https://doi.org/10.1007/s12098-020-03650-z

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  • DOI: https://doi.org/10.1007/s12098-020-03650-z

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