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Sanai FM, Keeffe EB. Liver biopsy for histological assessment: The case against. Saudi J Gastroenterol. 2010;16(2):124-32doi: 10.4103/1319-3767.61244.
Sanai, F. M., & Keeffe, E. B. (2010). Liver biopsy for histological assessment: The case against. Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association, 16(2), 124-32. https://doi.org/10.4103/1319-3767.61244
Sanai, Faisal M, and Keeffe, Emmet B. "Liver biopsy for histological assessment: The case against." Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association vol. 16,2 (2010): 124-32. doi: https://doi.org/10.4103/1319-3767.61244
Sanai FM, Keeffe EB. Liver biopsy for histological assessment: The case against. Saudi J Gastroenterol. 2010 Apr-Jun;16(2):124-32. doi: 10.4103/1319-3767.61244. PMID: 20339187; PMCID: PMC3016504.
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Saudi J Gastroenterol. 2010 Apr-Jun;16(2):124-32. doi: 10.4103/1319-3767.61244.

Liver biopsy for histological assessment: The case against.

Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association

Faisal M Sanai, Emmet B Keeffe

Affiliations

  1. Hepatology Unit, Department of Medicine, Riyadh Military Hospital, Riyadh, Saudi Arabia. [email protected]

PMID: 20339187 PMCID: PMC3016504 DOI: 10.4103/1319-3767.61244

Abstract

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.

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