A liver biopsy is a procedure that removes a sample of your liver for examination. Your doctor can use it to diagnose various liver conditions, like cirrhosis or chronic hepatitis.
There are several types of liver biopsies. One technique is called a transjugular liver biopsy. It’s called “transjugular” because it uses the jugular vein located in the neck to access the liver. The procedure is ideal for diagnosing liver conditions in people with certain risk factors.
In this article, we’ll discuss when a transjugular liver biopsy is needed, its potential side effects, and how it differs from a conventional liver biopsy.
A standard liver biopsy is known as a percutaneous liver biopsy. In general, it involves a fine needle that’s inserted into the skin on the side of the abdomen. The needle is then inserted into the liver in order to remove a sample of liver tissue.
A transjugular liver biopsy also involves a fine needle, but it enters the liver through a vein. Specifically, a fine needle and tube are inserted into the jugular vein in the neck, which then leads into one of the veins in the liver. This lets radiologists remove liver tissue via the jugular vein instead of through the abdomen.
Compared with a standard liver biopsy, a transjugular liver biopsy has a lower risk of bleeding. As a result, it may be a safer option for people who have bleeding issues.
This includes individuals who have:
Before a transjugular liver biopsy, your doctor may perform a blood test to check your blood’s clotting ability.
If there’s a problem with your blood clotting, you might need a blood transfusion or vitamin K shot. These treatments can help correct blood clotting and minimize the risk of bleeding after the biopsy.
If you’re taking blood-thinning medications, you might need to stop taking them several days before the procedure.
What to expect with the procedure
The biopsy will be performed by a radiologist. Here’s what will happen during a transjugular liver biopsy:
- After changing into a hospital gown, you’ll lie down on an X-ray table.
- The radiologist will use an ultrasound to locate your jugular vein.
- They’ll sanitize the area to reduce the risk of infection.
- Next, the radiologist will inject a local anesthetic into your neck area. This will prevent you from feeling any pain.
- The radiologist will then insert a fine needle and tube (catheter), into the vein.
- Using an X-ray, they’ll guide the tube into a vein in your liver. The X-ray will help them see the tube as it moves through your veins.
- Your radiologist will insert a device through the tube and into the liver. They’ll remove two or three samples of liver tissue through this tube.
- They might also inject an X-ray dye and take images of your liver.
- The radiologist will then remove the tube and apply pressure on your neck for 5 to 10 minutes to help stop any bleeding.
The entire process takes about 1 hour.
The recovery period after a transjugular liver biopsy is short. After the procedure, you’ll rest in a hospital bed for about 6 hours.
During this time, medical professionals will track your vital signs, including your temperature, pulse, and blood pressure.
If there are no issues, you’ll be able to leave that day. It’s recommended that you get a ride home after the procedure instead of driving yourself.
Like other liver biopsies, a transjugular liver biopsy can identify signs of liver disease or damage. This can help your doctor diagnose conditions like:
- liver disease
- chronic hepatitis
- liver damage, like drug-induced liver injury
- unexplained high liver enzyme levels
- liver cancer
It may also be used to evaluate your liver after a transplant.
A transjugular liver biopsy can obtain the same information as a percutaneous liver biopsy. But it also lets your doctors measure the pressure in your liver veins. They can do this while removing the sample of tissue.
A transjugular liver biopsy is a generally safe procedure. But like all procedures, there’s a risk of some complications.
The main risk is bleeding. Other possible side effects include:
After a transjugular liver biopsy, there’s a 1 to 2% risk of a complication that needs additional treatment.
Major side effects like hemorrhaging in or around the abdominal cavity are possible but extremely rare.
A transjugular liver biopsy is used to diagnose conditions of the liver. During the procedure, a radiologist inserts a fine needle and tube through your jugular vein, located in your neck. The tube will enter your liver, and the radiologist will remove tissue using a special device.
Compared to the standard percutaneous liver biopsy, this procedure is less likely to cause bleeding. That’s why it’s recommended for people who have a high risk of bleeding due to blood clotting disorders or other conditions.
Side effects are uncommon but possible. If you need a liver biopsy, your doctor can determine if this procedure is right for you.