The transjugular route as an alternative to direct percutaneous needle biopsy of the liver.

Transjugular liver biopsy was attempted in 32 cases of hepatocellular dysfunction with hemocoagulation disorders, ascites or marked obesity. A catheter was inserted in the right internal jugular vein and advanced into a hepatic vein under fluoroscopic control. A long needle was passed through the catheter and into the liver parenchyma for the biopsy. Diagnostic specimens were obtained in 28 instances (88%). The procedure was always well tolerated and no complications occurred. The transjugular approach offers a safe, practical alternative for liver biopsy in cases where direct percutaneous puncture is contraindicated.