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...

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Publicado en:Saudi Journal of Gastroenterology Vol. 16; no. 2; pp. 124 - 133
Autores principales: Sanai FM, Keeffe EB
Formato: standards tables/charts Journal Article
Publicado: Wolters Kluwer India Pvt Ltd Apr2010
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2010
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      pub: Wolters Kluwer India Pvt Ltd
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        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
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