Liver biopsy via jugular vein

(1) Choice of puncture needle: 18 G or 19 G puncture needle, transjugular liver biopsy kit, 0.035 inch guide wire, 9 F catheter sheath.

(2) Position: supine position, head to the opposite side of the puncture site.

(3) Disinfection and anesthesia: conventional ecg monitoring. Strictly aseptic operation, the operator wore masks, hats and aseptic gloves, routinely disinfected the punctured local skin, spread aseptic hole towel, and infiltrated the puncture site layer by layer with 2% lidocaine.

(4) Jugular vein puncture: Told the patient calm breathing, performer to deep vein needle into the jugular vein and suitable needle into the thread, visual monitoring operation guide wire under the catheter sheath, superior vena cava and right atrium, inferior vena cava in hepatic vein, hepatic vein angiography confirmed hepatic vein anatomy and scabbard head position, and exit the godet, insert the needle biopsy, instruct patients held her breath, The biopsy needle was inserted into the liver parenchyma 1~2 cm and the liver tissue samples were obtained quickly. Repeat the steps if there are insufficient specimens. After puncture, contrast agent was injected to check for abnormalities. The biopsy needle and catheter sheath were removed after surgery.

(5) Dressing: The puncture point was disinfected, the bleeding was stopped by pressing for 3 minutes, and the wound was dressed; After surgery, ecg monitoring and oxygen saturation were performed, and she was in bed for 4 h.

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