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Title: A Comparison of Transjugular and Plugged-Percutaneous Liver Biopsy in Patients with Contraindications to Ordinary Percutaneous Liver Biopsy and an 'In-House' Protocol for Selecting the Procedure of Choice

Abstract

The purpose of this study was to evaluate the effectiveness and safety of transjugular liver biopsy (TJLB) and plugged-percutaneous liver biopsy (PB) in consecutive patients with severe liver disease associated with impaired coagulation, ascites, or both and to verify the in-house protocol used to select the appropriate procedure. In 2000-2006, 329 patients (208 male [62.8%] and 121 female [37.2%]), aged 1 month to 81 years (mean, 46.8 years), underwent 150 TJLBs (39.1%) or 233 PBs (60.9%) procedures at a major tertiary center, as determined by an in-house protocol. The groups were compared for specimen characteristics, technical success, and complications. Technical success rates were 97.4% for TJLB (146/150) and 99.1% for PB (231/233). TJLB was associated with a lower average core length (1.29 vs. 1.43 cm) and lower average number of specimens obtained (2.44 vs. 2.8), but both methods yielded sufficient tissue for a definitive diagnosis. There were no major complications in either group. TJLB and PB can be safely and effectively performed for the diagnosis of hepatic disease in patients with contraindications for standard percutaneous liver biopsy. When both are technically available, we suggest PB as the procedure of choice, especially in transplanted livers.

Authors:
 [1];  [2]; ; ;  [1]; ;  [3];  [4];  [5];  [6];  [7];  [3]
  1. Hasharon Hospital, Vascular and Interventional Units, Department of Diagnostic Radiology (Israel)
  2. Beilinson Hospital, Liver Institute (Israel)
  3. Beilinson Hospital, Vascular and Interventional Units, Department of Diagnostic Radiology (Israel)
  4. Hasharon Hospital, Gastroenterology Unit (Israel)
  5. Institute of Gastroenterology, Rabin Medical Center, Unit of Liver Transplantation (Israel)
  6. Schneider Children Medical Center, Department of Pediatric Cardiology (Israel)
  7. Beilinson Hospital, Department of Internal Medicine (Israel)
Publication Date:
OSTI Identifier:
21428989
Resource Type:
Journal Article
Journal Name:
Cardiovascular and Interventional Radiology
Additional Journal Information:
Journal Volume: 33; Journal Issue: 3; Other Information: DOI: 10.1007/s00270-009-9743-z; Copyright (c) 2010 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Journal ID: ISSN 0174-1551
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ASCITES; BIOPSY; DISEASES; LIVER; BODY; DIAGNOSTIC TECHNIQUES; DIGESTIVE SYSTEM; GLANDS; ORGANS; PATHOLOGICAL CHANGES; SYMPTOMS

Citation Formats

Atar, Eli, E-mail: Atareli@hotmail.co, Ben Ari, Ziv, Bachar, Gil N., Amlinski, Yelena, Neyman, Chaim, Knizhnik, Michael, Litvin, Sergey, Schmilovitz-Weiss, Hemda, Shapiro, Riki, Bruckhaimer, Elchanan, Tur-Kaspa, Ran, and Belenky, Alexander. A Comparison of Transjugular and Plugged-Percutaneous Liver Biopsy in Patients with Contraindications to Ordinary Percutaneous Liver Biopsy and an 'In-House' Protocol for Selecting the Procedure of Choice. United States: N. p., 2010. Web. doi:10.1007/S00270-009-9743-Z.
Atar, Eli, E-mail: Atareli@hotmail.co, Ben Ari, Ziv, Bachar, Gil N., Amlinski, Yelena, Neyman, Chaim, Knizhnik, Michael, Litvin, Sergey, Schmilovitz-Weiss, Hemda, Shapiro, Riki, Bruckhaimer, Elchanan, Tur-Kaspa, Ran, & Belenky, Alexander. A Comparison of Transjugular and Plugged-Percutaneous Liver Biopsy in Patients with Contraindications to Ordinary Percutaneous Liver Biopsy and an 'In-House' Protocol for Selecting the Procedure of Choice. United States. doi:10.1007/S00270-009-9743-Z.
Atar, Eli, E-mail: Atareli@hotmail.co, Ben Ari, Ziv, Bachar, Gil N., Amlinski, Yelena, Neyman, Chaim, Knizhnik, Michael, Litvin, Sergey, Schmilovitz-Weiss, Hemda, Shapiro, Riki, Bruckhaimer, Elchanan, Tur-Kaspa, Ran, and Belenky, Alexander. Tue . "A Comparison of Transjugular and Plugged-Percutaneous Liver Biopsy in Patients with Contraindications to Ordinary Percutaneous Liver Biopsy and an 'In-House' Protocol for Selecting the Procedure of Choice". United States. doi:10.1007/S00270-009-9743-Z.
@article{osti_21428989,
title = {A Comparison of Transjugular and Plugged-Percutaneous Liver Biopsy in Patients with Contraindications to Ordinary Percutaneous Liver Biopsy and an 'In-House' Protocol for Selecting the Procedure of Choice},
author = {Atar, Eli, E-mail: Atareli@hotmail.co and Ben Ari, Ziv and Bachar, Gil N. and Amlinski, Yelena and Neyman, Chaim and Knizhnik, Michael and Litvin, Sergey and Schmilovitz-Weiss, Hemda and Shapiro, Riki and Bruckhaimer, Elchanan and Tur-Kaspa, Ran and Belenky, Alexander},
abstractNote = {The purpose of this study was to evaluate the effectiveness and safety of transjugular liver biopsy (TJLB) and plugged-percutaneous liver biopsy (PB) in consecutive patients with severe liver disease associated with impaired coagulation, ascites, or both and to verify the in-house protocol used to select the appropriate procedure. In 2000-2006, 329 patients (208 male [62.8%] and 121 female [37.2%]), aged 1 month to 81 years (mean, 46.8 years), underwent 150 TJLBs (39.1%) or 233 PBs (60.9%) procedures at a major tertiary center, as determined by an in-house protocol. The groups were compared for specimen characteristics, technical success, and complications. Technical success rates were 97.4% for TJLB (146/150) and 99.1% for PB (231/233). TJLB was associated with a lower average core length (1.29 vs. 1.43 cm) and lower average number of specimens obtained (2.44 vs. 2.8), but both methods yielded sufficient tissue for a definitive diagnosis. There were no major complications in either group. TJLB and PB can be safely and effectively performed for the diagnosis of hepatic disease in patients with contraindications for standard percutaneous liver biopsy. When both are technically available, we suggest PB as the procedure of choice, especially in transplanted livers.},
doi = {10.1007/S00270-009-9743-Z},
journal = {Cardiovascular and Interventional Radiology},
issn = {0174-1551},
number = 3,
volume = 33,
place = {United States},
year = {2010},
month = {6}
}