Transjugular liver biopsy
Catheter guided through the jugular vein and superior vena cava in the hepatic vein
Tissue samples are normally taken from the outside of the liver through the skin. However, if there are severe blood clotting disorders or abdominal fluid, there is an increased risk of bleeding with these punctures through the skin.
In these cases, the so-called transjugular liver puncture is used. This makes it possible to take a sample from the liver without damaging the liver capsule. A catheter is inserted into the inferior vena cava and then into the hepatic vein via the right jugular vein under X-ray guidance. A special instrument on the endoscope is then used to remove the liver tissue from the hepatic vein.
The procedure is somewhat more complex than conventional liver puncture and is only carried out under inpatient conditions.