Has anyone heard of Jugular vein biopsy?

[pishi1]

Hi, I am going to have a jugular vein biopsy soon and just wondered if anyone else has had the same procedure and what to expect from it.

Jane

[MisterX]

Hello,

Yes have heard of it. Haven't had one though.

The procedure is to thread a very fine tube through the vein in your neck to the main vein to the liver, at that point a needle is inserted (actually it's more like fired) to get a very small sample of liver tissue - it looks like a very very thin silk thread about an inch long.

It actually doesn't take all that long, about 30 minutes, and as far as I know isn't all that painful (and there aren't actually any nerves in the liver itself) - plus you'll be sedated.

Afterwards they'll keep an eye on you for several hours and make sure you're ok. They'll probably ask you to stay in a particular position for most of that time to help healing. You should be able to go home the same day but will have to avoid driving/operating machinery etc for 24 hours because of the sedative. Do check what you have to do in preparation for the procedure and do be strict about doing it.

Hope that helps. Some links explaining the procedure here - the last three are from the US and the last two get a bit more technical.

I'm sure if anyone here has had one and sees this they'll pitch in...

ouh.nhs.uk/patient-guide/le...

depts.washington.edu/uwvir/...

mayoclinic.org/tests-proced...

ncbi.nlm.nih.gov/pmc/articl...

Best of luck

[pishi1 in reply to MisterX]

Thanks for this. Not sure if it will tell me the cause of the liver damage. All blood tests were normal and sometimes they cannot find a cause. In the meantime, I was told that if I have an operation to remove the cyst there is 10 to 20 percent chance this may cause liver damage. I do need the op though as it has grown and causing tiredness and discomfort.

[Mama41 in reply to pishi1]

I've had 2 liver resections and am soon having a 3rd.

Liver surgery comes with a risk but i would think 10-20% risk of liver damage seems quite high.

Have they said what they think the cyst is?

If you're having it removed anyway i wouldn't bother having it biopsied. I would just have it removed.

[Bolly in reply to Mama41]

I agree with mama. Have it removed and let the medics biopsy it post surgery just to check its not malignant. Why go through the biopsy when you are having surgery anyway?

[pishi1 in reply to Mama41]

I am having a laparotomy where they'd take away ovaries, tubes, basically similar to hysterectomy. The cyst is near right ovary so this is the only way to get to it. My liver specialist said if I have the op there is a risk of liver damage but there is a risk in any surgery and I need to have this done. I suspect after the liver biopsy the gynae consultant will move quickly to arrange a date for the surgery.

[AyrshireK]

My hubby had his 2nd biopsy via the transjugular route, he had blood clotting issues so it was deemed the safer option and also the best for getting a proper sample - his first biopsy via the standard through the abdominal wall had gotten too poor/insufficient sample so the liver unit wanted to do it this way instead.

He says it was pain free except a small amount of slight discomfort in his right shoulder either when the sample was being taken or when they were extracting the needle - he doesn't really recall because he was sedated.

He found it straight forward and had no issues with it except the lengthy spell afterwards when he had to lie absolutely still for some hours. During this time he had to be regularly monitored.

He was an inpatient for his - going in the day before and getting out the day after but that may have been due to him having to be blood matched and have a platelet transfusion.

He's always said he'd prefer any number of biopsies over a single endoscopy so it is generally a very straightforward procedure.

If you like music or books i'd suggest taking your ipod or book with you because the long spell lying flat afterwards is a bit boring.

Wishing you all the best, Katie xx

[pishi1 in reply to AyrshireK]

Thank you. I agree, had the nasal spray for endoscopy and was gagging most of the time. Very unpleasant. I am patient generally so should not bother me.

[Steve-N]

When my consultant decided he wanted me to have a liver biopsy he and the doctor and Nursing staff told me there would be no pain... wrong it was agony right through. I was told that it would take just fifteen minutes... wrong it took one and a half hours. They said that they only needed to cut out one sample to send to the lab... wrong they cut off four samples. They did the whole biopsy with me having absolutely no pain relief and I was fully awake. The results came back about two hours after the biopsy was completed. Just shows that we are all individuals who experience these procedures in very different ways.

[dooley1 in reply to Steve-N]

Steve

I found the same to be true my liver biopsy through the ribs was very painful and traumatic I too had no sedation at all and a junior doc who hadn't done it before and kept hitting the stomach muscle ended up fainting and feeling quite rough afterward!! normally I'm a hard nut can tolerate most procedures well but this was another level. I don't understand why they do this procedure without sedation- barbaric!!!! 😖

[bantam12 in reply to dooley1]

I also had it done through the ribs and although the actual procedure went OK almost immediately after I was in agony and struggling to breath without immense pain, spent the rest of the day being topped up on morphine, the doc had caught the edge of my diaphragm with the needle, took me many weeks to recover. I will not be having another one !!

[dooley1 in reply to bantam12]

Sounds nasty, bit close to the lungs for comfort too!! neither would I have another one, not awake anyway!!

[RodeoJoe in reply to Steve-N]

Me too, I've had several. Every time it's agony. One time I don't know what they hit but they didn't get a liver biopsy. It left me throwing up and sweating from the pain.

I've also had the jugular one that was relatively painless.

[earthpixie]

Hi...had liver biopsy done this way....clotting issues..and v low red blood cell count....not sedated....local anaesthetic used on puncture site....but was completely covered except space for eyes and mouth....worst thing was sound of samples being taken....like a snipping sound from inside you....And you DO have to lie flat on your back for ages after...was an inpatient at the time....results took a long while.....few weeks..as sent to labs in London...Left with a tiny tiny hole on neck .....Not painful as such...not pleasant either....but results were needed.....Good luck....

[millymo]

Hi yes I have had two, theres nothing to worry about and its quite a quick procedure, they take a little bit of the liver through your neck instead of going in through your side and its quite painless,

[RodeoJoe]

Yes it's relatively painless. I had to have one because of blood clotting issues, but in the past (see other comment) had the "normal" one which was not at all painless.

There usually has to be a special reason like blood clotting for a jugular liver biopsy.

Actually it was a walk in the park compared to the "normal" one, the surgeons even had spotify and asked my to pick a sound track. Of course I was sedated and opted for some psychedelic, ambient Orb. Actually quite enjoyed the experience, definitely one of the best procedures I've had.

The worst of it is that I signed up for a medical trial, and they want to take another biopsy in a few months time. For trial purposes only. Damn!!!

[pwbr]

Because I have a very low platelet count, I had a transjugular liver biopsy.

I asked to be heavily sedated - and was - and have no recollection at all of the procedure due to the effect of the sedative

[Tatjana]

Hi Jane

I have had a biopsy the usual way through the liver and then one through the neck. I don't think I even realised what was happening when it was through the neck. I was given an appointment during which I remember I had various tests and my husband and I answered questions and asked them and then told I was having the Jugular Vein Biopsy and they did it there and then. Mine as I remember was was not painful.

Some days later I had my resection. At that time they diagnosed me with HCC but in the end when 'History' came in, it was EMZL Extranodel Marginal Zone Lymphoma.

From your replies you will see everyone had a different experience. I do remember saying after the jugular experience that it was sooo much better than direct into the liver biopsy.

I echo what Bolly and Mama41 suggest but, try it in a very diplomatic way!

[Bournemouth]

I had a procedure to check liver pressures etc. They went down the jugular vein. They freeze the area first with same drug as dentist does sting but only seconds. Then after they insert tube down there I didn't feel any pain all you feel is pressure and aware of tube in throat area more a strange feeling than pain I have had it done twice now and if had to have again don't look forward to it but it's not to bad it's the fear of the Unknown. Hope you get on ok I also have portal hypertension and get very uncomfortable in the stomach after eating digesting food is awful do you have the same problem. Thanks.

[pishi1]

Hello, I went through this procedure nearly a year ago. Yes, sometimes I get a bit of pain when digesting food from portal hypertension. I take a low dosage of carvedilol.