THE AIM OF THIS STUDY WAS TO EVALUATE THE APPLICABILITY, THE DIAGNOSTIC PROFITABILITY AND THE INCIDENCE OF COMPLICATIONS ASSOCIATED WITH TRANSJUGULAR LIVER-BIOPSY ASSOCIATED WITH THE MEASUREMENT OF THE HEPATICVENOUS-PRESSURE GRADIENT (HVPG)

BACKGROUND: The aim of this study was to evaluate the applicability, t he diagnostic profitability and the incidence of complications associa ted with transjugular liver biopsy associated with the measurement of the hepatic venous pressure gradient (HVPG). PATIENTS AND METHODS: The clinical histories of 829 consecutive patients in whom transjugular l iver biopsy was performed from 1982 to 1993 were reviewed, The diagnos tic value of the sample obtained was evaluated in all the patients and the HVPG determined, Moreover, the size of the greatest fragment obta ined during biopsy was also determined, RESULTS: Material for histolog ic study was obtained in 95% of the cases. In 70% the biopsy was diagn ostic, in 11% it provided data contributing to diagnosis and in 19% it was not useful, Potentially severe complications were presented in 0. 8% of cases being fatal in one (0.1%), The obtention of a fragment of small size was significantly associated with the presence of disease w ith marked fibrosis and high HVPG, A HVPG > 10 mmHg in patients with a suspicion of liver disease had a sensibility of 92% and a specificity of 63% for the diagnosis of hepatic cirrhosis, In 83% of patients wit h a GPVH > 10 mmHg in whom the biopsy was not useful, the diagnosis of hepatic cirrhosis was performed by other methods, CONCLUSIONS: Transj ugular biopsy in a safe, effective diagnostic method in patients with severe coagulation disorders. The appearance of the material obtained and the HVPG provide useful information for diagnosis although the bio psy is not diagnostic.