Liver biopsy for histological assessment -- the case against.
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...
| Publicado en: | Saudi Journal of Gastroenterology Vol. 16; no. 2; pp. 124 - 133 |
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| Autores principales: | , |
| Formato: | standards tables/charts Journal Article |
| Publicado: |
Wolters Kluwer India Pvt Ltd
Apr2010
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105169006&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105169006 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 13193767 322P jtl: Saudi Journal of Gastroenterology issn: 13193767 maglogo: N pubinfo: dt: Apr2010 vid: 16 iid: 2 pid: 16919 pub: Wolters Kluwer India Pvt Ltd artinfo: ui: 105169006 2010620514 10.4103/1319-3767.61244 NLM20339187 105169006 ppf: 124 ppct: 9 formats: tig: atl: Liver biopsy for histological assessment -- the case against. aug: au: Sanai FM Keeffe EB affil: Hepatology Unit, Department of Medicine, Riyadh Military Hospital, Riyadh, Saudi Arabia sug: subj: Biological Markers Biopsy Biopsy Adverse Effects Liver Anatomy and Histology Noninvasive Procedures Cost Benefit Analysis Risk Assessment Safety Sample Size Validity ab: 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. pubtype: Academic Journal doctype: standards tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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