Application of transjugular liver biopsy in the diagnosis and treatment of complicated and severe liver diseases

Hua TIAN; Qiang YU; Shaoli YOU; Sa LYU; Shuhong LIU; Bing ZHU

doi:10.3969/j.issn.1001-5256.2021.12.027

Volume 37 Issue 12

Dec. 2021

Turn off MathJax

Article Contents

Article Navigation > Journal of Clinical Hepatology > 2021 > 37(12): 2874-2877

PDF( 2586 KB)

Application of transjugular liver biopsy in the diagnosis and treatment of complicated and severe liver diseases

DOI: 10.3969/j.issn.1001-5256.2021.12.027

a.
Department of Liver Diseases, The Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China
b.
Department of Oncology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China
c.
Department of Pathology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China

Research funding:

Capital Clinical Characteristic Application Research on Funded Projects (Z151100004015019)

Received Date: 2021-05-24
Accepted Date: 2021-07-05
Published Date: 2021-12-20

Abstract

Abstract

Objective To investigate the application value of transjugular liver biopsy (TJLB) in the diagnosis and treatment of complicated and severe liver diseases. Methods A retrospective analysis was performed for the clinical data of 31 patients who underwent TJLB in The Fifth Medical Center of Chinese PLA General Hospital, including indication for puncture, success rate, and final diagnosis. Results Among the 31 patients, there were 15 male patients and 16 female patients. Percutaneous liver biopsy was unsuitable for 8 patients with liver failure and disturbances of blood coagulation, 13 with liver cirrhosis and ascites, and 10 with liver cirrhosis and thrombocytopenia (< 50×10⁹/L), which were the indications for TJLB. The success rate of TJLB puncture was 100%, with 2-4 passes for puncture. No serious adverse event was observed. Of all 31 patients, 26 (83.87%) had a definite diagnosis at discharge, among whom there were 5 patients with idiopathic portal hypertension, 9 patients with drug-induced liver failure or liver cirrhosis, 5 patients with autoimmune liver disease, and 7 patients with liver cirrhosis or liver failure due to other causes, and 5 patients had unknown etiology. In addition, 3 patients underwent biopsy to confirm the diagnosis and decision of whether liver transplantation should be performed. Conclusion TJLB plays an important role in the diagnosis and treatment of complicated and severe liver diseases and still has certain limitations, and therefore, suitable patients should be selected in clinical practice.
- Liver Diseases,
- Biopsy, Needle,
- Diagnosis,
- Therapeutics

FullText(HTML)

References(17)

References

[1]	BRAVO AA, SHETH SG, CHOPRA S. Liver biopsy[J]. N Engl J Med, 2001, 344(7): 495-500. DOI: 10.1056/NEJM200102153440706.
[2]	DOHAN A, GUERRACHE Y, BOUDIAF M, et al. Transjugular liver biopsy: Indications, technique and results[J]. Diagn Interv Imaging, 2014, 95(1): 11-15. DOI: 10.1016/j.diii.2013.08.009.
[3]	CADRANEL JF, NOUSBAUM JB, GOUILLOU M, et al. Major changes in the number and indications of liver biopsy for chronic liver diseases over one decade in France[J]. Eur J Gastroenterol Hepatol, 2016, 28(9): e26-e32. DOI: 10.1097/MEG.0000000000000683.
[4]	LYU S, YOU SL, YU Q, et al. Feasibility and significance of transjugular liver biopsy in diagnosis and treatment of complicated and severe liver diseases: A single-center analysis of 5 cases[J]. Chin J Hepatol, 2017, 25(10): 772-774. DOI: 10.3760/cma.j.issn.1007-3418.2017.10.011. 吕飒, 游绍莉, 余强, 等. 经颈静脉肝穿刺活组织检查在疑难重症肝病诊治中的可行性及意义: 单中心5例患者分析[J]. 中华肝脏病杂志, 2017, 25(10): 772-774. DOI: 10.3760/cma.j.issn.1007-3418.2017.10.011.
[5]	CRAWFORD AR, LIN XZ, CRAWFORD JM. The normal adult human liver biopsy: A quantitative reference standard[J]. Hepatology, 1998, 28(2): 323-331. DOI: 10.1002/hep.510280206.
[6]	YOU SL, ZHU B, RONG YH, et al. Diagnosis analysis of 9453 cases with liver diseases[J]. Chin J Health Care Med, 2012, 14(6): 459-462. DOI: 10.3969/j.issn.1674-3245.2012.06.017. 游绍莉, 朱冰, 荣义辉, 等. 9453例待查肝病的诊断分析[J]. 中华保健医学杂志, 2012, 14(6): 459-462. DOI: 10.3969/j.issn.1674-3245.2012.06.017.
[7]	BERNAL W, WENDON J. Acute liver failure[J]. N Engl J Med, 2013, 369(26): 2525-2534. DOI: 10.1056/NEJMra1208937.
[8]	YOU S, RONG Y, ZHU B, et al. Changing etiology of liver failure in 3, 916 patients from northern China: A 10-year survey[J]. Hepatol Int, 2013, 7(2): 714-720. DOI: 10.1007/s12072-013-9424-5.
[9]	European Association for the Study of the Liver. EASL clinical practice guidelines: Vascular diseases of the liver[J]. J Hepatol, 2016, 64(1): 179-202. DOI: 10.1016/j.jhep.2015.07.040.
[10]	KHANNA R, SARIN SK. Non-cirrhotic portal hypertension-diagnosis and management[J]. J Hepatol, 2014, 60(2): 421-441. DOI: 10.1016/j.jhep.2013.08.013.
[11]	REN Y, ZHENG SJ. Progress of idiopathic portal hypertension[J]. Chin J Gastroenterol Hepatol, 2019, 28(6): 708-710. DOI: 10.3969/j.issn.1006-5709.2019.06.025. 任艳, 郑素军. 特发性门脉高压研究现状[J]. 胃肠病学和肝病学杂志, 2019, 28(6): 708-710. DOI: 10.3969/j.issn.1006-5709.2019.06.025.
[12]	MACK CL, ADAMS D, ASSIS DN, et al. Diagnosis and management of autoimmune hepatitis in adults and children: 2019 practice guidance and guidelines from the American Association for the Study of Liver Diseases[J]. Hepatology, 2020, 72(2): 671-722. DOI: 10.1002/hep.31065.
[13]	ZHAO LH, JIA JD. Etiological diagnosis and standard treatment of portal hypertension should be taken seriously[J]. J Clin Hepatol, 2019, 35(1): 10-12. DOI: 10.3969/j.issn.1001-5256.2019.01.001. 赵连晖, 贾继东. 应重视门静脉高压症的病因诊断及规范治疗[J]. 临床肝胆病杂志, 2019, 35(1): 10-12. DOI: 10.3969/j.issn.1001-5256.2019.01.001.
[14]	Chinese Portal Hypertension Diagnosis and Monitoring Study Group (CHESS), Minimally Invasive Intervention Collaborative Group, Chinese Society of Gastroenterology, Emergency Intervention Committee, Chinese College of Interventionalists, et al. Consensus on clinical application of hepatic venous pressure gradient in China (2018)[J]. J Clin Hepatol, 2018, 34(12): 2526-2536. DOI: 10.3969/j.issn.1001-5256.2018.12.008. 中国门静脉高压诊断与监测研究组(CHESS), 中华医学会消化病学分会微创介入协作组, 中国医师协会介入医师分会急诊介入专业委员会, 等. 中国肝静脉压力梯度临床应用专家共识(2018版)[J]. 临床肝胆病杂志, 2018, 34(12): 2526-2536. DOI: 10.3969/j.issn.1001-5256.2018.12.008.
[15]	ROCKEY DC, CALDWELL SH, GOODMAN ZD, et al. Liver biopsy[J]. Hepatology, 2009, 49(3): 1017-1044. DOI: 10.1002/hep.22742.
[16]	BEHRENS G, FERRAL H. Transjugular liver biopsy[J]. Semin Intervent Radiol, 2012, 29(2): 111-117. DOI: 10.1055/s-0032-1312572.
[17]	BEHRENS G, FERRAL H, GIUSTO D, et al. Transjugular liver biopsy: Comparison of sample adequacy with the use of two automated needle systems[J]. J Vasc Interv Radiol, 2011, 22(3): 341-345. DOI: 10.1016/j.jvir.2010.10.012.

Relative Articles

Supplements(0)

Cited By

Proportional views

Proportional views

通讯作者: 陈斌, bchen63@163.com

1.
沈阳化工大学材料科学与工程学院沈阳 110142

Figures(1) / Tables(1)

Get Citation

PDF

XML

Article Metrics

Article views (535) PDF downloads(54)

Application of transjugular liver biopsy in the diagnosis and treatment of complicated and severe liver diseases

DOI: 10.3969/j.issn.1001-5256.2021.12.027

Abstract

References

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

Application of transjugular liver biopsy in the diagnosis and treatment of complicated and severe liver diseases

DOI: 10.3969/j.issn.1001-5256.2021.12.027

Abstract

References

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

About Journal

Submission Guideline

Journal Online

Hepatobiliary College

Guidelines

Export File

Citation

Format

Content