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152例患者经颈静脉肝活检的单中心经验。

Single centre experience of transjugular liver biopsy in 152 patients.

作者信息

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

机构信息

Department of Diagnostic Radiology, Singapore General Hospital, Singapore.

出版信息

Ann Acad Med Singap. 2014 Mar;43(3):160-5.

Abstract

INTRODUCTION

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.

MATERIALS AND METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

引言

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。

材料与方法

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。

结果

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)。

结论

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。

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