Abstract: Objective The aim of this study was to investigate application of transjugular liver biopsy (TJLB) in patients with creptogenic liver diseases. Methods Fouty-seven patients with creptogenic liver diseases were encountered in our hospital between December 2023 and May 2024, and all underwent TJLB for histo-pathological examination. The key operating points and possible complications were summarized. Results All patients (100.0%)completed the operation; the obtained liver tissues were one to five bars, average of 3.0±0.9 bars, with 0.2 to 2.5 cm (average:1.1±0.4 cm); under microscopy, 2 to 24 portal areas were found (average:7.8±4.9); with combination of serology study, the histo-pathological examination diagnosed autoimmune hepatitis (AIH)in 13 cases, creptogenic nodular liver cirrhosis in 6 cases, unavailable diagnosis because of too little tissues in 4 cases, primary biliary cholangitis (PBC) in 4 cases, drug-induced liver injury (DILI) in 3 cases, connective tissue hyperplasia(CTH) in 3 cases, fatty liver in 2 cases, creptogenic liver diseases in 2 cases, hepatocyte spotty necrosis in 2 cases, AIH-PBC overlapping syndrome (OS)in 2 cases, idiopathic non-cirrhotic portal hypertension in 1 case,cavernous transformation of the portal vein (CTPV) in 1 case, small bile duct hyperplasia in 1 case, scattered inflammatory cell infiltration in 1 case, nonalcoholic steatohepatitis (NASH) in 1 case and normal liver tissue manifestation in 1 case; 1 patient (2.1%)developed subcapsular hemorrhage after the operation and recovered by appropriate management. Conclusion Transjugular liver biopsy is an alternative useful approach to obtain liver tissue samples, which might helpful to determine diagnosis for clinicians to make an early management.

Key words: Creptogenic liver diseases, Transjugular liver biopsy, Key points of protocol, Complications, Diagnosis