Saudi Journal of Gastroenterology

DEBATE
Year
: 2010  |  Volume : 16  |  Issue : 2  |  Page : 124--132

Liver biopsy for histological assessment - the case against


Faisal M Sanai1, Emmet B Keeffe2 
1 Hepatology Unit, Department of Medicine, Riyadh Military Hospital; Liver Disease Research Center - King Saud University, Riyadh, Saudi Arabia
2 Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University Medical Center, Stanford, CA, USA

Correspondence Address:
Faisal M Sanai
Division of Gastroenterology and Hepatology (A41), Department of Medicine, Riyadh Military Hospital, PO Box 7897, Riyadh-11159
Saudi Arabia

Percutaneous liver biopsy (LB) remains an important tool in the diagnosis and management of parenchymal liver diseases. In current practice, it is most frequently performed to assess the inflammatory grade and fibrotic stage of commonly encountered liver diseases, with the diagnostic role relegated to secondary importance. The role of LB remains a vastly controversial and debated subject, with an ever-increasing burden of evidence that questions its routine application in all patients with liver dysfunction. It remains, essentially, an invasive procedure with certain unavoidable risks and complications. It also suffers shortcomings in diagnostic accuracy since a large liver sample is required for an ideal assessment, which in clinical practice is not feasible. LB is also open to observer interpretation and prone to sampling errors. In recent years, a number of noninvasive biomarkers have evolved, each with an impressive range of diagnostic certainty approaching that achieved with LB. These noninvasive tests represent a lower-cost option, are easily reproducible, and serve as suitable alternatives to assess hepatic inflammation and fibrosis. This article aims to debate the shortcomings of LB while simultaneously demonstrating the diagnostic accuracy, reliability and usefulness of noninvasive markers of liver disease thereby making the case for their utilization as suitable alternatives to LB in many, although not all, circumstances.


How to cite this article:
Sanai FM, Keeffe EB. Liver biopsy for histological assessment - the case against.Saudi J Gastroenterol 2010;16:124-132


How to cite this URL:
Sanai FM, Keeffe EB. Liver biopsy for histological assessment - the case against. Saudi J Gastroenterol [serial online] 2010 [cited 2020 Aug 9 ];16:124-132
Available from: http://www.saudijgastro.com/article.asp?issn=1319-3767;year=2010;volume=16;issue=2;spage=124;epage=132;aulast=Sanai;type=0