Cholongitas, E.; Quaglia, A.; Samonakis, D.; Senzolo, M.; Triantos, C.; Patch, D.; Leandro, G.; ... Burroughs, A.K.; + view all Cholongitas, E.; Quaglia, A.; Samonakis, D.; Senzolo, M.; Triantos, C.; Patch, D.; Leandro, G.; Dhillon, A.P.; Burroughs, A.K.; - view fewer (2006) Transjugular liver biopsy: how good is it for accurate histological interpretation? Gut , 55 (12) pp. 1789-1794. 10.1136/gut.2005.090415.

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Abstract

Background: A transjugular liver biopsy (TJLB) specimen is often smaller or more fragmented than a percutaneous liver biopsy (PLB) specimen. Recently, for PLB, the minimum requirements to evaluate chronic hepatitis have been set at 20–25 mm length and 11 complete portal tracts. Aim: To evaluate and compare length of TJLB and PLB specimens, portal tract number, fragmentation and adequacy for histopathological diagnosis and staging. Patients and methods: 326 consecutive TJLB specimens in 274 patients (109 who had undergone a transplantation), always using three passes (19-G Tru-cut) and 40 consecutive PLB specimens (15-G Menghini). Results: No technical failures occurred with the TJLB, and histological diagnosis was possible in 98.5%. The median (range) number of fragments was 5 (1–13) and the median total length was 22 (3–46) mm, with 65% of specimens 20 mm and 36% 25 mm; 60% of TJLB specimens were 28 mm long had 11 complete portal tracts. No difference in complete portal tract number or biopsy length was found between PLB and TJLB specimens. Conclusion: A TJLB specimen with three passes is adequate for histological diagnosis, with 89% of specimens being either 15 mm or having 6 complete portal tracts. Although adequate sampling remains a limitation for staging and grading of chronic hepatitis, TJLB is comparable to PLB in this respect.

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