Patel Ankur, Gogna Apoorva, Irani Farah Gillan, Teo Terence K B, Yeow Tow Non, Jain Deepak, Lo Richard H G, Tay Kiang Hiong, Tan Bien Soo, Azhar Rafay, Chang Jason P E, Taneja Manish
Department of Diagnostic Radiology, Singapore General Hospital, Singapore.
Ann Acad Med Singap. 2014 Mar;43(3):160-5.
Liver biopsy is considered the definitive investigation in the diagnosis and management of liver disease. This study describes the experience of performing transjugular liver biopsy (TJLB) over the last 9 years in a local single centre.
A retrospective review of consecutive TJLB procedures performed at our institution was conducted. A total of 152 patients (74 males and 78 females), with a mean age of 47.4 years (range, 13 to 83 years) underwent a total of 154 TJLB procedures at our institution between March 2003 and November 2011. The principal indication for TJLB was severe coagulopathy in over 80% of patients. The technical success, number of passes, histological adequacy and complication rates were analysed.
The procedural success rate was 98.7% (152 out of 154 procedures). Adequate material for diagnosis was obtained in 149 out of 152 (98.0%) technically successful procedures. There was procedure related morbidity in 8 patients (5.2%) of which all but one were self-limiting requiring no further intervention. We also performed hepatic venous pressure gradient (HVPG) measurements in 19% of patients at the time of TJLB.
TJLB performed at our institution is a safe and reliable technique in patients in whom traditional percutaneous liver biopsy may be hazardous. TJLB has a high technical success rate as well as a high diagnostic yield with a low complication rate. TJLB also has the added benefit of performing HVPG, which is of increasing importance in management and prognostication of chronic liver disease.
肝活检被认为是肝病诊断和管理中的决定性检查方法。本研究描述了在当地一家单中心过去9年中进行经颈静脉肝活检（TJLB）的经验。
对在我们机构进行的连续TJLB手术进行回顾性研究。2003年3月至2011年11月期间，共有152例患者（74例男性和78例女性），平均年龄47.4岁（范围为13至83岁）在我们机构接受了总共154次TJLB手术。超过80%的患者进行TJLB的主要指征是严重凝血功能障碍。分析了技术成功率、穿刺次数、组织学充分性和并发症发生率。
手术成功率为98.7%（154例手术中的152例）。在152例技术成功的手术中，有149例（98.0%）获得了足够的诊断材料。8例患者（5.2%）出现与手术相关的并发症，其中除1例以外均为自限性，无需进一步干预。我们还在19%的患者进行TJLB时测量了肝静脉压力梯度（HVPG）。
在我们机构进行的TJLB对于传统经皮肝活检可能有风险的患者来说是一种安全可靠的技术。TJLB具有较高的技术成功率和诊断率，并发症发生率低。TJLB还具有进行HVPG测量的额外优势，这在慢性肝病的管理和预后评估中越来越重要。
