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Updated: Sep 15, 2025
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Measurement of the Hepatic Venous Pressure Gradient and Transjugular Liver Biopsy
Published on: June 18, 2020
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Transjugular diagnostic procedures in hepatology: Indications, techniques and interpretation
Dominik Bettinger1, Annalisa Berzigotti2, Mattias Mandorfer3
1Department of Medicine II, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, D-79106 Freiburg, Germany.
JHEP Reports : Innovation in Hepatology
|July 18, 2025
Summary
Hepatic venous pressure gradient (HVPG) measurement and transjugular liver biopsy are key hepatology tools. HVPG ≥10 mmHg identifies significant portal hypertension, crucial for managing advanced chronic liver disease.
Area of Science:
- Hepatology
- Gastroenterology
- Interventional Procedures
Background:
- Hepatic venous pressure gradient (HVPG) measurement is the gold standard for diagnosing portal hypertension.
- Transjugular liver biopsy offers an alternative to percutaneous biopsy, especially in patients with specific complications.
- Emerging non-invasive tests and endoscopic approaches are being investigated.
Purpose of the Study:
- To summarize critical technical aspects of HVPG measurements.
- To provide an overview of transjugular liver biopsy techniques.
- To discuss the current role of these procedures alongside new diagnostic methods.
Main Methods:
- Review of technical aspects of HVPG measurement.
- Description of transjugular liver biopsy procedures.
- Analysis of the clinical utility in compensated advanced chronic liver disease (cACLD).
Main Results:
- HVPG ≥10 mmHg is a critical prognostic threshold in cACLD.
- Transjugular biopsy is advantageous in patients with coagulopathy, ascites, or obesity.
- Standardization of endoscopic ultrasound-guided procedures is needed.
Conclusions:
- HVPG measurement and transjugular liver biopsy remain vital in clinical hepatology.
- These invasive methods are essential for accurate diagnosis and prognosis in liver disease.
- The integration of new non-invasive and endoscopic techniques requires further research and validation.
Keywords:
CirrhosisHVPGPSVDhepatic venous pressure gradientminimally invasiveportal hypertensionporto-sinusoidal vascular disordertransjugular liver biopsyMore Related Videos
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