Transjugular liver biopsy: enlarge the indications for liver biopsy with reliable diagnostic quality.
Complication
Diagnostic efficiency
Propensity score matching
Transjugular liver biopsy
Journal
BMC gastroenterology
ISSN: 1471-230X
Titre abrégé: BMC Gastroenterol
Pays: England
ID NLM: 100968547
Informations de publication
Date de publication:
14 Aug 2023
14 Aug 2023
Historique:
received:
16
02
2023
accepted:
07
08
2023
medline:
16
8
2023
pubmed:
15
8
2023
entrez:
14
8
2023
Statut:
epublish
Résumé
Complications and diagnostic efficiency for liver biopsy are main concerns for clinicians. This study aimed to assess the safety and efficacy of transjugular liver biopsy (TJLB) compared with percutaneous liver biopsy (PLB) when patients had equal level of liver function and number of passes, using propensity score matching (PSM). The clinical and pathological data of patients who received TJLB or PLB between January 2012 and October 2022 were collected. Matching factors included age, gender, cirrhosis, portal hypertension, liver function, creatinine, number of passes, hemodialysis, history of anti-coagulation and anti-platelet, and comorbidities. Coagulation indexes were not considered as matching factors due to different indications of the two techniques. 2711 PLBs and 30 TJLBs were evaluated. By PSM, 75 patients (50 PLBs, 25 TJLBs) were matched. The complication rates for TJLB and PLB were 4.0% (1/25) and 10.0% (5/50) (P > 0.05). Two PLBs had hepatic hemorrhage, one of which required only close monitoring (Grade 1) and the other needed hemostasis and rehydration therapy (Grade 2). The other 3 cases presented with mild abdominal pain (Grade 1). And only one TJLB presented with mild pain. The median number of complete portal tracts were 6.0 and 10.0 for TJLBs and PLBs (P < 0.05). Moreover, the median length of sample for TJLBs and PLBs were 10.0 and 16.5 mm (P < 0.05). The diagnostic efficiency of hepatopathy of unknown etiology of TJLB versus PLB groups before and after matching were 96.4% vs. 94.1% and 95.7% vs. 93.2%, respectively (P > 0.05). TJLB is an effective invasive diagnostic procedure that expands indications for liver biopsy with reliable diagnostic quality.
Sections du résumé
BACKGROUND
BACKGROUND
Complications and diagnostic efficiency for liver biopsy are main concerns for clinicians. This study aimed to assess the safety and efficacy of transjugular liver biopsy (TJLB) compared with percutaneous liver biopsy (PLB) when patients had equal level of liver function and number of passes, using propensity score matching (PSM).
METHODS
METHODS
The clinical and pathological data of patients who received TJLB or PLB between January 2012 and October 2022 were collected. Matching factors included age, gender, cirrhosis, portal hypertension, liver function, creatinine, number of passes, hemodialysis, history of anti-coagulation and anti-platelet, and comorbidities. Coagulation indexes were not considered as matching factors due to different indications of the two techniques.
RESULTS
RESULTS
2711 PLBs and 30 TJLBs were evaluated. By PSM, 75 patients (50 PLBs, 25 TJLBs) were matched. The complication rates for TJLB and PLB were 4.0% (1/25) and 10.0% (5/50) (P > 0.05). Two PLBs had hepatic hemorrhage, one of which required only close monitoring (Grade 1) and the other needed hemostasis and rehydration therapy (Grade 2). The other 3 cases presented with mild abdominal pain (Grade 1). And only one TJLB presented with mild pain. The median number of complete portal tracts were 6.0 and 10.0 for TJLBs and PLBs (P < 0.05). Moreover, the median length of sample for TJLBs and PLBs were 10.0 and 16.5 mm (P < 0.05). The diagnostic efficiency of hepatopathy of unknown etiology of TJLB versus PLB groups before and after matching were 96.4% vs. 94.1% and 95.7% vs. 93.2%, respectively (P > 0.05).
CONCLUSION
CONCLUSIONS
TJLB is an effective invasive diagnostic procedure that expands indications for liver biopsy with reliable diagnostic quality.
Identifiants
pubmed: 37580680
doi: 10.1186/s12876-023-02917-x
pii: 10.1186/s12876-023-02917-x
pmc: PMC10426161
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
282Subventions
Organisme : Nature Science Foundation of Chin
ID : 81970454
Organisme : Key projects of Jiangsu Provincial Health Commission
ID : ZD2021061
Informations de copyright
© 2023. BioMed Central Ltd., part of Springer Nature.
Références
Bissonnette J, Riescher-Tuczkiewicz A, Gigante E, Bourdin C, Boudaoud L, Soliman H, Durand F, Ronot M, Valla D, Vilgrain V, et al. Predicting bleeding after liver biopsy using comprehensive clinical and laboratory investigations: a prospective analysis of 302 procedures. J Thromb Haemost. 2022;20(12):2786–96.
doi: 10.1111/jth.15888
pubmed: 36128757
pmcid: 9828241
Chi H, Hansen BE, Tang WY, Schouten JN, Sprengers D, Taimr P, Janssen HL, de Knegt RJ. Multiple biopsy passes and the risk of complications of percutaneous liver biopsy. Eur J Gastroenterol Hepatol. 2017;29(1):36–41.
doi: 10.1097/MEG.0000000000000731
pubmed: 27556687
Khalifa A, Rockey DC. The utility of liver biopsy in 2020. Curr Opin Gastroenterol. 2020;36(3):184–91.
doi: 10.1097/MOG.0000000000000621
pubmed: 32097176
Neuberger J, Patel J, Caldwell H, Davies S, Hebditch V, Hollywood C, Hubscher S, Karkhanis S, Lester W, Roslund N, et al. Guidelines on the use of liver biopsy in clinical practice from the british Society of Gastroenterology, the Royal College of Radiologists and the Royal College of Pathology. Gut. 2020;69(8):1382–403.
doi: 10.1136/gutjnl-2020-321299
pubmed: 32467090
Rockey DC, Caldwell SH, Goodman ZD, Nelson RC, Smith AD. American Association for the study of liver D: liver biopsy. Hepatology. 2009;49(3):1017–44.
doi: 10.1002/hep.22742
pubmed: 19243014
De Gottardi A, Rautou PE, Schouten J, Rubbia-Brandt L, Leebeek F, Trebicka J, Murad SD, Vilgrain V, Hernandez-Gea V, Nery F, et al. Porto-sinusoidal vascular disease: proposal and description of a novel entity. Lancet Gastroenterol Hepatol. 2019;4(5):399–411.
doi: 10.1016/S2468-1253(19)30047-0
pubmed: 30957754
de Franchis R, Bosch J, Garcia-Tsao G, Reiberger T, Ripoll C, Baveno VIIF. Baveno VII - renewing consensus in portal hypertension. J Hepatol. 2022;76(4):959–74.
doi: 10.1016/j.jhep.2021.12.022
pubmed: 35120736
Terjung B, Lemnitzer I, Dumoulin FL, Effenberger W, Brackmann HH, Sauerbruch T, Spengler U. Bleeding complications after percutaneous liver biopsy. An analysis of risk factors. Digestion. 2003;67(3):138–45.
doi: 10.1159/000071293
pubmed: 12853725
Dohan A, Guerrache Y, Dautry R, Boudiaf M, Ledref O, Sirol M, Soyer P. Major complications due to transjugular liver biopsy: incidence, management and outcome. Diagn Interv Imaging. 2015;96(6):571–7.
doi: 10.1016/j.diii.2015.02.006
pubmed: 25771477
Kalambokis G, Manousou P, Vibhakorn S, Marelli L, Cholongitas E, Senzolo M, Patch D, Burroughs AK. Transjugular liver biopsy–indications, adequacy, quality of specimens, and complications–a systematic review. J Hepatol. 2007;47(2):284–94.
doi: 10.1016/j.jhep.2007.05.001
pubmed: 17561303
Ble M, Procopet B, Miquel R, Hernandez-Gea V, Garcia-Pagan JC. Transjugular liver biopsy. Clin Liver Dis. 2014;18(4):767–78.
doi: 10.1016/j.cld.2014.07.001
pubmed: 25438282
Sue MJ, Lee EW, Saab S, McWilliams JP, Durazo F, El-Kabany M, Kaldas F, Busuttil RW, Kee ST. Transjugular Liver Biopsy: safe even in patients with severe Coagulopathies and multiple biopsies. Clin Transl Gastroenterol. 2019;10(7):e00063.
doi: 10.14309/ctg.0000000000000063
pubmed: 31259750
pmcid: 6708667
Stift J, Semmler G, Walzel C, Mandorfer M, Schwarzer R, Schwabl P, Paternostro R, Scheiner B, Woran K, Pinter M, et al. Transjugular aspiration liver biopsy performed by hepatologists trained in HVPG measurements is safe and provides important diagnostic information. Dig Liver Dis. 2019;51(8):1144–51.
doi: 10.1016/j.dld.2019.01.020
pubmed: 30862438
Behrens G, Ferral H. Transjugular liver biopsy. Semin Intervent Radiol. 2012;29(2):111–7.
doi: 10.1055/s-0032-1312572
pubmed: 23729981
pmcid: 3444875
Coral GP, Antunes AD, Serafini AP, Araujo FB, Mattos AA. Liver biopsy: importance of Specimen size in the diagnosis and staging of chronic viral Hepatitis. Rev Inst Med Trop Sao Paulo. 2016;58:10.
doi: 10.1590/S1678-9946201658010
pubmed: 26910447
pmcid: 4793951
Singh S, Allen AM, Wang Z, Prokop LJ, Murad MH, Loomba R. Fibrosis progression in nonalcoholic fatty liver vs nonalcoholic steatohepatitis: a systematic review and meta-analysis of paired-biopsy studies. Clin Gastroenterol Hepatol. 2015;13(4):643–54. e641-649; quiz e639-640.
doi: 10.1016/j.cgh.2014.04.014
pubmed: 24768810
Donmez H, Kahriman G, Ozcan N, Mavili E, Deniz K. Transjugular liver biopsy: results of 97 patients. Balkan Med J. 2012;29(2):129–32.
doi: 10.5152/balkanmedj.2011.022
pubmed: 25206981
pmcid: 4115860