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Jing H, Yi Z, He E, Xu R, Shi X, Li L, Sun L, Liu Y, Zhang L, Qian L. Evaluation of Risk Factors for Bleeding After Ultrasound-Guided Liver Biopsy. Int J Gen Med 2021; 14:5563-5571. [PMID: 34539186 PMCID: PMC8444981 DOI: 10.2147/ijgm.s328205] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 08/17/2021] [Indexed: 12/18/2022] Open
Abstract
Purpose This study was performed to analyze the risk factors for hemorrhagic complications after ultrasound-guided liver biopsies. Patients and Methods In this retrospective study, we reviewed 1193 ultrasound-guided percutaneous liver biopsies performed in our hospital from January 2018 to December 2020. Relevant patient characteristics, indications for biopsy, laboratory findings, biopsy technique, hemorrhagic complications, and pathologic outcomes were collected. Results We analyzed 834 procedures performed on 807 patients with complete data. The bleeding group comprised 45 patients with post-procedure bleeding, and non-bleeding group comprising the remaining 789 patients. Univariate analysis showed that age (p < 0.001), number of needle passes (p = 0.009), platelet count (p = 0.002), prothrombin time (p < 0.001), and international normalized ratio (p < 0.001) were associated with post-procedure bleeding. Multivariable regression analysis showed that age under 18 years (p < 0.001), low platelet count (p = 0.001), and increased needle passes (p = 0.025) were independent risk factors for bleeding complications. Conclusion Sex and focal liver lesions did not affect the risk of post-procedure bleeding. The international normalized ratio and prothrombin time were associated with an increased incidence of bleeding; however, they had no predictive value. Age, number of needle passes, and platelet count were identified as reliable predictors of bleeding.
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Affiliation(s)
- Haoyu Jing
- Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
| | - Zhanxiong Yi
- Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
| | - Enhui He
- Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
| | - Ruifang Xu
- Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
| | - Xianquan Shi
- Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
| | - Li Li
- Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
| | - Liying Sun
- Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
| | - Ying Liu
- Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
| | - Liang Zhang
- Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
| | - Linxue Qian
- Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
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Lee EW, Sue MJ, Saab S, DiNorcia J, McWilliams JP, Kaldas F, Ding PX, Padia SA, Agopian V, Farmer D, Busuttil RW. Accuracy and Safety of 1,055 Transjugular Liver Biopsies in Postliver Transplant Patients. Clin Transl Gastroenterol 2021; 12:e00355. [PMID: 34018491 PMCID: PMC8140774 DOI: 10.14309/ctg.0000000000000355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 04/05/2021] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION The purpose of this study was to investigate the rates of complications and diagnostic yield of transjugular liver biopsy (TJLB) in deceased donor liver transplant (DDLT) recipients. METHODS From January 2009 to December 2019, 1,055 TJLBs were performed in 603 adult DDLT recipients with a mean age of 54 (±12 years). Data were retrospectively reviewed to determine the diagnostic efficacy and incidence of major and minor complications in the 3-day and 1-month period after TJLB. In addition, data were stratified according to platelet count and international normalized ratio to determine the safety of TJLB in patients with varying degrees of coagulopathy. RESULTS TJLB yielded diagnostic rate of 98.1% (1,035/1,055), with an overall complication rate of 8.3% (88/1,055). Major complications accounted for 0.85% (9/1,055), and minor complications occurred in 7.48% (79/1,055). When patients were stratified by platelet count (0-50, 51-100, 101-200, 201-300, and >300 × 103 platelets/μL), no significant difference was noted in complication rates (9.5%, 8.6%, 7.6%, 8.5%, and 10.7%, respectively). When grouped by international normalized ratio (0-1, 1.1-2.0, 2.1-3.0, and >3.0), there was no statistical difference in complication rates (8.3%, 8.5%, 7.7%, and 0%, respectively). DISCUSSION TJLB is a safe, adequate, and effective method to investigate hepatic disorders in DDLT recipients with severe coagulopathy.
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Affiliation(s)
- Edward Wolfgang Lee
- Division of Interventional Radiology, Department of Radiology, UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
- Dumont-UCLA Transplant Center, Pfleger Liver Institute, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA
| | - Megan J. Sue
- Division of Interventional Radiology, Department of Radiology, UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Sammy Saab
- Department of Medicine, Division of Hepatology, Pfleger Liver Institute, University of California at Los Angeles, Los Angeles, California, USA
| | - Joseph DiNorcia
- Dumont-UCLA Transplant Center, Pfleger Liver Institute, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA
| | - Justin P. McWilliams
- Division of Interventional Radiology, Department of Radiology, UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Fady Kaldas
- Dumont-UCLA Transplant Center, Pfleger Liver Institute, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA
| | - Peng-xu Ding
- Division of Interventional Radiology, Department of Radiology, UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Siddharth A. Padia
- Division of Interventional Radiology, Department of Radiology, UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Vatche Agopian
- Dumont-UCLA Transplant Center, Pfleger Liver Institute, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA
| | - Douglas Farmer
- Dumont-UCLA Transplant Center, Pfleger Liver Institute, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA
| | - Ronald W. Busuttil
- Dumont-UCLA Transplant Center, Pfleger Liver Institute, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA
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Dey M, Das S, Chatterjee A, Dutta A, Ghosh R, Dasgupta J. Yield and Safety of Transjugular Versus Percutaneous Liver Biopsies in Suspected Cases of Diffuse Liver Disease and Correlation of Yield of Transjugular Liver Biopsy with Hepatic Venous Pressure Gradient. JOURNAL OF GASTROINTESTINAL AND ABDOMINAL RADIOLOGY 2021. [DOI: 10.1055/s-0040-1716605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Abstract
Background Liver biopsy is indicated in both diagnosis and prognosis of diffuse liver diseases. Conventionally, percutaneous liver biopsy (PLB) is used, as it is easily available, affordable and has a shorter procedure time, whereas transjugular liver biopsy (TJLB) is used in the setting of ascites and coagulopathy. Our aim is to evaluate the diagnostic yield of TJLB in comparison to PLB with tract embolization. Our secondary aims were to evaluate whether there is any difference in rate of major and minor complications between the two procedures and evaluate whether there is any correlation between diagnostic yield of TJLB and hepatic venous pressure gradient (HVPG).
Methods In this retrospective study, we included a total of consecutive 123 patients who underwent liver biopsy through percutaneous (n = 97) and transjugular route (n = 26). We compared the yield of the specimen based on the number of complete portal tracts (CPT).
Results There was no significant difference between mean CPT in TJLB and PLB specimens (mean CPT of TJLB and PLB were 10.9 ± 2.7 and 11.6 ±2.5, respectively [p = 0.566]). There was a moderate but significant negative correlation between the total number of CPT and HVPG in the TJLB group (Spearman’s rho − 0.58) (p = 0.002). There was no statistically significant difference in minor complication between the two procedures. Only one patient who underwent PLB developed major complication and none of TLJB procedure had any major complication.
Conclusion Yield of tissue and complication rates are comparable in TJLB and PLB groups. Yield of tissue in TJLB have intermediate but significant negative correlation with HVPG.
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Affiliation(s)
- Mousam Dey
- Division of Radiodiagnosis, Department of Intervention Radiology, Indian Institute of Liver and Digestive Sciences, Kolkata, West Bengal, India
| | - Simi Das
- Department of Radiodiagnosis, Ruby General Hospital, Kolkata, West Bengal, India
| | - Argha Chatterjee
- Department of Radiology and Imaging, Tata Medical Center, Kolkata, West Bengal, India
| | - Agnibha Dutta
- Division of General Medicine, Department of Gastroenterology, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
| | - Ranajoy Ghosh
- Department of Pathology, GI Pathology, School of Digestive and Liver Diseases, IPGMER, Kolkata, West Bengal, India
| | - Jayanta Dasgupta
- Department of Gastroenterology, Indian Institute of Liver and Digestive Sciences, Kolkata, West Bengal, India
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Zhu YJ, Cheng DL, Zhou CZ, Lv WF. Clinical application of transjugular liver biopsy. Shijie Huaren Xiaohua Zazhi 2020; 28:1200-1205. [DOI: 10.11569/wcjd.v28.i23.1200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND With the increasing incidence of liver diseases, liver biopsy plays an increasingly important role in the diagnosis and treatment of acute or chronic liver diseases. Although percutaneous liver biopsy has been widely used in clinical practice, transjugular liver biopsy (TJLB) is a safe and effective alternative for patients with contraindications to percutaneous liver biopsy, especially for patients with diffuse liver disease. Although TJLB has been widely carried out abroad, there are only a few related reports in domestic hospitals due to equipment reasons.
AIM To discuss the safety and feasibility of using LABS 100 intrahepatic biopsy needle set produced by COOK company for TJLB in patients with contraindications to or high risk factors for percutaneous liver biopsy.
METHODS The clinical data of ten patients who underwent TJLB at our hospital from November 2019 to March 2020 were analyzed retrospectively, including indications, success rate of operation, complications, and sampling results.
RESULTS The success rate of operation was 100% and the complication rate was 10%, and all patients got enough liver tissue and pathological diagnosis.
CONCLUSION TJLB is a safe and effective method for patients who are not suitable for percutaneous liver biopsy. Although TJLB has been widely carried out abroad, it is rarely carried out in China.
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Affiliation(s)
- Yi-Jiang Zhu
- Department of Interventional Radiology, The First Affiliated Hospital of University of Science and Technology of China, Hefei 230001, Anhui Province, China
| | - De-Lei Cheng
- Department of Interventional Radiology, The First Affiliated Hospital of University of Science and Technology of China, Hefei 230001, Anhui Province, China
| | - Chun-Ze Zhou
- Department of Interventional Radiology, The First Affiliated Hospital of University of Science and Technology of China, Hefei 230001, Anhui Province, China
| | - Wei-Fu Lv
- Department of Interventional Radiology, The First Affiliated Hospital of University of Science and Technology of China, Hefei 230001, Anhui Province, China
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