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Updated: Jul 5, 2025
Measurement of the Hepatic Venous Pressure Gradient and Transjugular Liver Biopsy
Published on: June 18, 2020
Complications in hepatic vein catheterisation and transjugular liver biopsy
Nanna Hansen1, Annette Dam Fialla1,2
1Department of Gastroenterology and Hepatology, Odense University Hospital.
Insights
Hepatic vein catheterisation (HVC) and transjugular liver biopsy (TJLB) are safe procedures for managing cirrhosis complications. While HVC showed a 3.3% complication rate and TJLB had a 6.8% rate, most complications were minor, with no fatalities reported.
Area of Science:
- Hepatology
- Interventional Radiology
- Gastroenterology
Background:
- Portal pressure is a key predictor of decompensation in cirrhosis.
- Hepatic vein catheterisation (HVC) and transjugular liver biopsy (TJLB) are established procedures for assessing portal pressure.
- Understanding indications and complications is crucial for patient safety and procedural optimization.
Purpose of the Study:
- To identify the primary indications for performing HVC and TJLB.
- To analyze the 30-day postprocedural complication rates associated with HVC and TJLB.
- To evaluate the safety profile of these invasive procedures in a clinical setting.
Main Methods:
- A retrospective analysis of procedures performed between January 1, 2018, and January 31, 2022.
- Utilized procedure codes to identify patients and extracted data from electronic health records.
- Collected information on indications, complications, patient demographics, diagnoses, comorbidities, and laboratory tests.
Main Results:
- HVC was frequently indicated for beta-blocker therapy control and diagnosis.
- TJLB indications included diagnostic and research purposes.
- Complications for HVC were minor (pain, arrhythmias); TJLB had four major bleeding complications requiring admission.
Conclusions:
- Both HVC and TJLB are confirmed as safe procedures in managing cirrhosis.
- The overall complication rates were 3.3% for HVC and 6.8% for TJLB.
- Complications were predominantly minor, with no reported mortality, underscoring the safety of these interventions.
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.
