OBJECTIVES To investigate the safety profile and diagnostic efficacy of transjugular liver biopsy (TJLB), with a focus on patients with severe coagulopathies and with multiple biopsies. METHODS Clinical, laboratory, and demographic information was collected on 1,321 TJLBs in 932 patients (mean age 43.5 ± 23.2 years) performed between January 2009 and May 2017 to determine the diagnostic success rate and incidence of both major and minor complications in the 3-day and 30-day period post-biopsies. These outcomes were also analyzed for severely coagulopathic patients and a subgroup of patients who underwent multiple biopsies. RESULTS The overall success rate (diagnostic yield) of the TJLB procedure was 97.7% (1,291/1,321). Overall, the major and minor complication rates were 1.0% (13/1,321) and 9.5% (126/1,321), respectively. In patients with multiple biopsies, the overall complication rate was similar to the entire study cohort, which was 10.4% (57/550). Patients were also stratified according to the platelet counts of 0-50, 51-100, 101-200, 201-300 and >300 × 10 platelets/μL. The overall complication rates were 8.0% (10/124), 11.6% (36/310), 9.9% (54/547), 11.9% (28/235), and 14.3% (11/77), respectively, and these were not statistically significant from each other. Patients were also stratified by international normalized ratio into 0-1, 1.1-2, 2.1-3, and >3. The overall complication rates of these patients were 8.0% (19/237), 11.8% (113/954), 16.3% (7/43), and 0% (0/9), respectively, and were not statistically significant from each other. DISCUSSION TJLB is a highly efficacious, well-tolerated and safe procedure. It can be safely performed multiple times in the same patient or in critically ill, severely coagulopathic patients with no significant increase in the rate of complication while maintaining an extremely favorable diagnostic yield.

中文翻译：

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经颈静脉肝穿刺活检：即使对于严重的咽部病变和多次活检的患者也很安全。

目的研究经颈静脉肝穿刺活检（TJLB）的安全性和诊断功效，重点是患有严重凝血病和多次活检的患者。方法收集2009年1月至2017年5月进行的932例患者（平均年龄43.5±23.2岁）的1,321例TJLB的临床，实验室和人口统计学信息，以确定3天内诊断成功率以及主要和次要并发症的发生率活检后30天。还对严重凝血障碍患者和接受多次活检的患者亚组分析了这些结局。结果TJLB手术的总成功率为97.7％（1,291 / 1,321）。总体而言，主要和次要并发症发生率分别为1.0％（13 / 1,321）和9.5％（126 / 1,321）。在进行多次活检的患者中，总并发症发生率与整个研究队列相似，为10.4％（57/550）。还根据血小板计数0-50、51-100、101-200、201-300和> 300×10血小板/μL对患者进行分层。总体并发症发生率分别为8.0％（10/124），11.6％（36/310），9.9％（54/547），11.9％（28/235）和14.3％（11/77），这些彼此之间没有统计学意义。还按照国际标准化比率将患者分为0-1、1.1-2、2.1-3和> 3。这些患者的总并发症发生率分别为8.0％（19/237），11.8％（113/954），16.3％（7/43）和0％（0/9），并且在每组中均无统计学意义其他。讨论TJLB是一种高效，耐受性强且安全的手术。