Due to technological advancements and the widespread use of diagnostic imaging modalities in current clinical practice focal liver lesions are increasingly being discovered. Differentiation of these lesions is considered to be critical for determining treatment options. In this regard, histological assessment of the liver, liver biopsy remains a cornerstone in the evaluation and management of patients with liver disease. Despite that sensitive and relatively accurate blood tests used to detect and diagnose liver disease have now become widely available, liver biopsy will remain a valuable diagnostic tool. It has currently three major roles: (1) diagnosis, (2) assessment of prognosis (disease staging), and/or (3) to assist in making therapeutic management decisions.
Several techniques may be used to obtain liver tissue. These include a percutaneous method, a transvenous (transjugular or transfemoral), an endoscopic (transgastric) approach as well as intra-abdominal biopsy (laparoscopic or laparotomic). While in case of percutaneous approach ultrasound guidance is the favored modality, computed tomography (CT), magnetic resonance (MR) and fusion imaging techniques have all been used.
In the present chapter we summarize the current practice of liver biopsy with an emphasis on the indications, contraindications, technique and risk of complications.
KeywordsLiver biopsy Percutaneous liver biopsy Histopathology Ultrasound-assisted liver biopsy
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