Complications in hepatic vein catheterisation and transjugular liver biopsy

Dan Med J. 2023 Dec 18;71(1):A06230413.

Abstract

Introduction: Portal pressure predicts the occurrence of decompensations in cirrhosis. Portal pressure is primarily measured via hepatic vein catheterisation (HVC), to which a transjugular liver biopsy (TJLB) may be added. Indications for HVC are mainly therapy control and prognosis. TJLB is performed when a percutaneous liver biopsy is contraindicated or for other diagnostic reasons. Both procedures have reported low complication rates. The aim of this study was to identify indications and 30-day postprocedural complications.

Methods: Based on procedure codes, a list was generated in the report database compromising procedures from 1 January 2018 to 31 January 2022. Procedures were identified in electronic charts (Cosmic Arkiv). A total of 209 patients undergoing 277 procedures were included. Information regarding indications, complications, age, sex, diagnosis, comorbidity and blood tests was also analysed.

Results: The more frequently reported indications for HVC were control of betablockers and diagnosis. Indications for TJLB were diagnostic and research purposes. Complications after HVC included pain and transient supraventricular arrythmias. Four major complications after TJLB were found, which led to admission due to various causes of bleeding.

Conclusion: HVC and TJLB are safe procedures. The complication rate for HVC and TJLB was 3.3% and 6.8%, respectively. Complications were minor; only four major complications after TJLB were found - none of which were mortal.

Funding: None.

Trial registration: Not relevant.

MeSH terms

  • Biopsy / methods
  • Catheterization
  • Hepatic Veins* / pathology
  • Humans
  • Jugular Veins / pathology
  • Liver / pathology
  • Liver Diseases* / pathology