Complications from Transjugular Liver Biopsy

Abstract

Purpose: Transjugular liver biopsy (TLB) is an invasive diagnostic procedure extremely useful in assessing liver disease in all kinds of coagulopathy patients. We have analysed the type of complications from this technique, considering all the steps involved, including jugular, cardiac and liver catheterization. Methods: We analysed retrospectivly 1000 TLB, performed in 14 years. 350 were achieved with TJ Henriksen aspiration needle, and 650 with TruCut needle. Results: The complications that we observed were: carotid punction in 28 patients (2,8%), that did not preclude the liver biopsy; cervical haematoma in 12 patients (1,2%), without arterial puncture; transient auricular arrythmia in 15 patients (1,5%), that did not need pharmacological intervention or suspending the procedure; lumbar pain in inferior vena cava catheterization (without dissection) in 3 patients (0,3%); right hipocondrial pain in distal catheterization of hepatic veins, pre biopsy, in 5 patients (0,5%); ascitic fluid recovery in aspirative biopsy in 2 patients (0,2%); hemobilia in 1 patient (0,1%), with pain, hyperamilasemia and oozing from the papilla; convulsion during lydocaine anesthesia in 1 patient (0,1%). In 8 patients, the access was from left jugular vein. We did not have any complications related to the usual premedication (25–50 mg, iv, meperidine), to contrast allergy or to inadverted puncture of any cardiac afluent. Conclusions: Even in serious and delicate conditions that the candidates for this procedure present, the complication rate, 6,7%, is exceptionally low, and generally quite benign and of minor importance. This suggests TLB as an extremelly useful and safe tool in assisting acute or chronic severe liver disease patients.