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The Practice of Percutaneous Liver Biopsy in a Gastrohepatology Day Hospital: A Retrospective Study on 835 Biopsies

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Abstract

The evolving role of liver biopsy has induced the formulation of several guidelines on its appropriateness. However, the great divergence among hepatologists is still unresolved. We report the 4-year activity of a day hospital of gastrohepatology in northern Italy. Between January 2001 and July 2004, 835 subjects (mean age, 43±12 years) underwent this procedure in our facility. Etiologically, in 465 (56%) and 157 (19%) patients, chronic hepatitis C and nonspecific elevated liver biochemical tests were the first and second indications, followed by chronic hepatitis B and suspected nonalcoholic steatohepatitis. On a purpose basis, procedures requested for staging (n = 578) and/or for diagnosis (n = 217) were identified. Among the former, 80% had the scope of staging chronic hepatitis C, and in 15% of these unsuspected superimposed cirrhosis was detected. Among diagnostic procedures, nonspecific raised liver enzyme level ranked first. Twenty-two percent of patients reported unwanted effects following the procedure. In conclusion, these data accord with indications expressed by international guidelines. The impact of liver biopsy on therapeutic decision-making needs to be studied further.

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References

  1. Gunneson TJ, Menon N, Wiesner RH, et al. (2002) Ultrasound-assisted percutaneous liver biopsy performed by a physician assistant. Am J Gastroenterol 97:1472–1475

    Article  PubMed  Google Scholar 

  2. van Leeuwen DJ (2001) The imager replacing the pathologists in the assessment of hepatobiliary and pancreatic disease. Ann Diagn Pathol 5:57–66

    Article  PubMed  CAS  Google Scholar 

  3. Myers RP, Tainturier MH, Ratziu V, et al. (2003) Prediction of liver histological lesions with biochemical markers in patients with chronic hepatitis B. J Hepatol 39:222–230

    Article  PubMed  CAS  Google Scholar 

  4. Chuah SY, Moody GA, Wicks AC, Mayberry JF (1994) A nationwide survey of liver biopsy– Is there a need to increase resources, manpower and training? Hepatogastroenterology 41:4–8

    PubMed  CAS  Google Scholar 

  5. Jacobs WH, Goldberg SB (1989) Statement on out-patient percutaneous liver biopsy. Dig Dis Sci 34:322–323

    Article  PubMed  CAS  Google Scholar 

  6. Grant A, Neuberger J (1999) Guidelines on the use of liver biopsy in clinical practice. Gut 45 (Suppl 4):IV1–IV11

    Article  PubMed  Google Scholar 

  7. Almasio PL, Niero M, Angioli D, et al. (2005) Experts’ opinion on the role of liver biopsy in HCV infection: a Delphi survey by the Italian Association of Hospital Gastroenterologists (A.I.G.O.). J Hepatol 43:222–230

    Article  Google Scholar 

  8. Ishak K, Baptista A, Bianchi L, et al. (1995) Histological grading and staging of chronic hepatitis. J Hepatol 22:696–699

    Article  PubMed  CAS  Google Scholar 

  9. Hübscher SG (2004) Role of liver biospy in the assessment of non-alcoholic fatty liver disease. Eur J Gastroenterol Hepatol 16:1107–1115

    Article  PubMed  Google Scholar 

  10. van Leeuwen DJ (2002) Liver biopsy: Who should do it and who will show up in court? Am J Gastroenterol 97:1285–1288

    Article  PubMed  Google Scholar 

  11. Saracco G, Borghesio E, Mesina P, et al. (1997) Prolonged treatment (2 years) with different doses (3 versus 6 MU) of interferon-2b for chronic hepatitis type C. J Hepatol 27:56–62

    Article  PubMed  CAS  Google Scholar 

  12. Ciancio A, Smedile A, Giordanino C, et al. (2006) Long-term follow-up of previous hepatitis C virus positive nonresponders to interferon monotherapy successfully retreated with combination therapy: Are they really cured? Am J Gastroenterol 101:1811–1816

    Google Scholar 

  13. Pellicano R, Craxì A, Almasio PL, et al. (2005) Interferon beta-1a alone or in combination with ribavirin: a randomized trial to compare efficacy and safety in chronic hepatitis C. World J Gastroenterol 11:4484–4489

    PubMed  CAS  Google Scholar 

  14. Daniel S, Ben-Menachem T, Vasudevan G, et al. (1999) Prospective evaluation of unexplained chronic liver transaminase abnormalities in asymptomatic and symptomatic patients. Am J Gastroenterol 94:3010–3014

    Article  PubMed  CAS  Google Scholar 

  15. Bugianesi E, Manzini P, D’Antico S, et al. (2004) Relative contribution of iron burden, HFE mutations, and insulin resistance to fibrosis in non-alcoholic fatty liver. Hepatology 39:179–187

    Article  PubMed  CAS  Google Scholar 

  16. Puoti C (2003) HCV carriers with persistently normal aminotransferase levels: normal does not always mean healthy. J Hepatol 38:529–532

    Article  PubMed  CAS  Google Scholar 

  17. Campbell MS, Reddy KR (2004) Review article: The evolving role of liver biopsy. Aliment Pharmacol Ther 20:249–259

    Article  PubMed  CAS  Google Scholar 

  18. Gebo KA, Herlong HF, Torbenson MS, et al. (2002) Role of liver biopsy in management of chronic hepatitis C: a systematic review. Hepatology 36:S161–S172

    Article  PubMed  Google Scholar 

  19. Lagget M, Actis GC, Brunetto MR, Verme G, Bonino F (1992) Treating chronic liver disease: lessons from a day-hospital. Ital J Gastroenterol 24:242–244

    PubMed  CAS  Google Scholar 

  20. Capocaccia L, Gandolfi L (1998) Analysis of the organisational aspects of gastroenterology services in Italy. Ital J Gastroenterol Hepatol 30:451–461

    PubMed  CAS  Google Scholar 

  21. Perrault J, McGill DB, Ott BJ, Taylor WF (1978) Liver biopsy: complications in 1000 inpatients and outpatients. Gastroenterology 74:103–106

    PubMed  CAS  Google Scholar 

  22. Verveer C, De Knegt RJ (2006) Non-invasive measurement of liver fibrosis: application of the Fibroscan (R) in hepatology. Scand J Gastroenterol Suppl 243:85–88

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Gastro-Hepatology and Clinical Nutrition, San Giovanni Battista (Molinette) Hospital, Torino, 10126, Italy

    Giovanni Clemente Actis, Alda Olivero, Marco Lagget, Rinaldo Pellicano, Antonina Smedile & Mario Rizzetto

  2. Day Hospital of Gastro-Hepatology, Ospedale Molinette, corso Bramante n.88, Torino, 10100, Italy

    Giovanni Clemente Actis

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  1. Giovanni Clemente Actis
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  2. Alda Olivero
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  3. Marco Lagget
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  4. Rinaldo Pellicano
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  5. Antonina Smedile
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  6. Mario Rizzetto
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Correspondence to Giovanni Clemente Actis.

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Actis, G.C., Olivero, A., Lagget, M. et al. The Practice of Percutaneous Liver Biopsy in a Gastrohepatology Day Hospital: A Retrospective Study on 835 Biopsies. Dig Dis Sci 52, 2576–2579 (2007). https://doi.org/10.1007/s10620-006-9724-x

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  • DOI: https://doi.org/10.1007/s10620-006-9724-x

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