Transjugular liver biopsy using ultrasonographic guidance for jugular vein puncture and an automated device for hepatic tissue sampling: a retrospective analysis of 200 consecutive cases

Background

We retrospectively evaluated the value of the combination of ultrasonographic guidance for jugular vein puncture and an automated biopsy device for transjugular liver biopsy.

Methods

Transjugular liver biopsy was performed with ultrasonographic guidance for right internal jugular vein puncture and an automated device for hepatic tissue sampling (Quick-Core^®) in 200 consecutive patients in whom percutaneous transhepatic biopsy was contraindicated. Histopathologic specimens were reviewed for adequacy and complications related to the procedure were analyzed.

Results

Biopsies were technically successful in 198 of 200 (99%) patients. The two cases of technical failure were due to an acute angle between right hepatic vein and inferior vena cava (1%). Adequate gross hepatic tissue specimens (mean length, 11. 0 mm ± 5.3; range, 5.0–20.0 mm) were obtained in 198 (99%) patients, allowing definitive histological diagnosis in 196 of 198 patients, for an overall success rate of 98%. Neither cases of inadvertent injury of the carotid artery nor life-threatening intraperitoneal bleeding were observed. Minor complications were noted in 24/200 (12%) patients.

Conclusion

The combination of ultrasonographic guidance for jugular vein puncture and an automated biopsy device for tissue sampling is recommended for transjugular liver biopsy as it results in a safe, well-tolerated, and efficient technique.