Medicine of the Future in America

The role of liver biopsy in the management of patients with liver disease: INDICATIONS FOR LIVER BIOPSY

Liver biopsies are performed for diagnostic and prognostic reasons. Histopathological examination is the best method for making the diagnosis when noninvasive tests are inconclusive. In cases in which the diagnosis has already been established by other means, it may reveal additional diagnoses as well as information on disease severity. For example, although laboratory and imaging tests may suggest the presence of cirrhosis, liver biopsy remains the definitive procedure for this purpose. Moreover, it can help stage the disease and estimate its prognosis. Serial biopsies can document the progression of chronic conditions such as hepatitis C (HCV).

If liver biopsies provide useful information for the management of patients with liver disease, why is there so much debate in the medical community about performing them? The explanation is that the procedure is associated with inconvenience, pain, and a risk of significant bleeding, albeit small . Therefore, experts disagree as to whether histologic assessment should be part of the standard management in patients with liver disease.

Sherwood and colleagues retrospectively assessed the outcome of nearly 1000 patients with abnormal liver enzymes in the primary care setting. They found that only 57% of patients (531 of 933) were referred for specialized care. Of the remaining 342 patients who had follow-up visits, 157 had persistently abnormal liver enzymes, and were invited to return for further assessment. Liver biopsies were eventually performed in 101 (64%) patients from this cohort, and yielded a definitive diagnosis in 81 patients despite normal serological tests. The authors concluded that a substantial proportion of patients with treatable and sometimes communicable chronic liver disease would not have been diagnosed had they not undergone liver biopsy, and that the procedure remains a useful diagnostic tool. Very cheap drugs at your disposal – buy viagra super active online to get best deals at best pharmacy.

This entry was posted in Angioedema, Liver disease and tagged Alcoholic liver disease, Liver biopsy, Nonalcoholic steatohepatitis, Viral hepatitis.
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