Transjugular liver biopsies (TJLB)

    Transjugular liver biopsies (TJLB)-

  • To establish the etiology of chronic liver disease (once routine panel of etiological workup is negative) liver biopsy is required. Normally it can be done through transabdominal percutaneous route. But in case of ascites or coagulopathy, transabdominal liver biopsy is not safe and hence TJLB is done via internal jugular vein. It is safe procedure but has small risks of complications. Prior to procedure the gastroenterologist will discuss with the patient and their relatives the benefits, risks, alternatives and technical details of TJLB.

    Hepatic venous Pressure gradient (HVPG) measurement-

  • HVPG is measured to document portal hypertension and measures the pressure gradient between portal vein and hepatic vein. Value more than 5 mm Hg is considered to establish portal hypertension. HVPG has prognostic significance in a liver disease patient since it can predict the risk of bleed from esophageal varices. HVPG can also assess the response of medications to reduce the portal pressure (Propranolon/carvedilol). It is safe procedure but has small risks of complications. Prior to procedure the gastroenterologist will discuss with the patient and their relatives the benefits, risks, alternatives and technical details of HVPG.

DR. Tarun Bhardwaj