Transjugular liver biopsy
experience with the trucut needle
DOI:
https://doi.org/10.22491/2357-9730.126031Keywords:
Liver, needles, biopsy needle, transjugular liver biopsyAbstract
OBJECTIVES: We describe the use of transjugular liver biopsy with the automated trucut needle and emphasize the benefits of this procedure in patients with cirrhosis and fibrosis.
METHODS: Puncture of the right or left internal jugular vein was performed. A needle was advanced into the right hepatic vein through guides and catheters. Biopsies were obtained from the right liver lobe. Thirty-six transjugular biopsies were performed in 35 patients with clinical diagnosis of hepatopathy; all patients presented contraindication to the standard percutaneous liver biopsy.
RESULTS: Out of 36 transjugular liver biopsies, one patient had to repeat the procedure because the initial specimen did not allow diagnosis. In two patients, it was not possible to complete the biopsy due to inability to advance the needle into the right hepatic vein and due to the occurrence of extrasystole; in these cases, the procedure was discontinued. Biopsy was successfully performed in 34 patients (94%), and a conclusive diagnosis was obtained in 32 (89%). There were no relevant complications.
CONCLUSIONS: Transjugular liver biopsy allowed histopathological diagnosis in a group of patients presenting contraindications to the standard percutaneous technique. With the trucut needle, it was possible to obtain large, nonfragmented specimens, even in patients with cirrhosis and fibrosis.
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