Transjugular liver biopsy in patients with unexplained liver dysfunction and bleeding tendency: a safety and efficacy analysis

BACKGROUND: Transjugular liver biopsy (TJLB) enables histopathological diagnosis of liver disease and simultaneous assessment of the hepatic venous pressure gradient (HVPG). AIMS: To assess the diagnostic adequacy and safety of TJLB in combination with HVPG measurement in patients with unexplained Liver Dysfunction and hemorrhage tendency. METHODS: Seventy-seven TJLB procedures were performed in 58 patients with unexplained liver dysfunction using the COOK Medical TJLB kit. Biopsy quality was assessed by specimen length, number of complete portal tracts, diagnostic yield, and procedure-related complications. Subgroup analyses were conducted according to HVPG levels. RESULTS: All procedures yielded adequate histopathological samples. The mean specimen length was 8 mm (range, 5–13 mm), with a mean of 9 complete portal tracts (range, 4–20). TJLB identified the underlying etiology in 72.4% of patients, including 70.7% of those with ascites and 72.7% of those with coagulopathy. Among patients who underwent HVPG measurement, higher HVPG values were associated with shorter specimen length and fewer portal tracts. No procedure-related complications were observed. CONCLUSIONS: TJLB combined with HVPG measurement is a safe and effective approach for diagnosing liver disease in patients with unexplained liver dysfunction and bleeding tendency.