TRANSJUGULAR LIVER-BIOPSY - COMPARISON WITH PERCUTANEOUS LIVER-BIOPSY

A transjugular liver biopsy was performed on 60 patients. Specimens we re successfully obtained from 57 (95%) patients. Specimens obtained fr om cirrhotic patients were frequently small-sized/fragmented. The wedg e hepatic venous pressure and hepatic venous pressure gradient were hi gher in patients with small-sized/fragmented specimens than those with non-fragmented specimens (16.3+/-6.4 vs 12.3+/-4.9 and 10.9+/-6.2 vs 7.3+/-3.4 mmHg, P < 0.05, respectively). During the same period of tim e, percutaneous liver biopsies were consecutively performed on 277 pat ients. The liver specimens by transjugular method were generally small er (0.63+/-0.58 vs 1.50+/-0.86 cm, P < 0.001) and more fragmented (63% vs 16%, P < 0.01) than those obtained by percutaneous method. Biopsy specimens obtained for diagnosis by the former method were inadequate from 6 (10%) patients and by the latter route were inadequate from 7 ( 2%) patients. Subcapsular haematoma in one patient was associated with the transjugular liver biopsy. Minor complications occurred in three patients: neck haematoma in two and paroxysmal supraventricular tachyc ardia during the procedure in one. In comparison, percutaneous liver b iopsy was followed by minor complications in 20 patients and major com plications in four patients. It is concluded that transjugular liver b iopsy is a safe, valuable and alternative procedure to obtain liver sp ecimens, especially in patients who were contraindicated for percutane ous liver biopsy.