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  • Guidelines on the use of liver biopsy in clinical practice from the British Society of Gastroenterology, the Royal College of Radiologists and the Royal College of Pathology

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Guidelines
Guidelines on the use of liver biopsy in clinical practice from the British Society of Gastroenterology, the Royal College of Radiologists and the Royal College of Pathology
  1. James Neuberger1,
  2. Jai Patel2,
  3. Helen Caldwell3,
  4. Susan Davies4,
  5. Vanessa Hebditch5,
  6. Coral Hollywood6,
  7. Stefan Hubscher7,
  8. Salil Karkhanis8,
  9. Will Lester9,
  10. Nicholas Roslund10,
  11. Rebecca West5,
  12. Judith I Wyatt11,
  13. Mathis Heydtmann12
  1. 1 Liver Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
  2. 2 Department of Vascular Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
  3. 3 Liver Unit, Royal Liverpool and Broadgreen Hospitals NHS Trust, Liverpool, UK
  4. 4 Department of Histopathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
  5. 5 British Liver Trust, Ringwood, UK
  6. 6 Department of Gastroenterology, Gloucestershire Royal Hospital, Gloucester, UK
  7. 7 Department of Pathology, University of Birmingham, Birmingham, UK
  8. 8 Department of Radiology, Queen Elizabeth Hospital Birmingham, Birmingham, UK
  9. 9 Department of Haematology, Queen Elizabeth Hospital, Birmingham, UK
  10. 10 Patient Representative, London, UK
  11. 11 Department of Pathology, St James University Hospital, Leeds, UK
  12. 12 Department of Gastroenterology, Royal Alexandra Hospital, Glasgow, UK
  1. Correspondence to Dr James Neuberger, Liver Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2PR, UK; jamesneuberger{at}hotmail.co.uk

Abstract

Liver biopsy is required when clinically important information about the diagnosis, prognosis or management of a patient cannot be obtained by safer means, or for research purposes. There are several approaches to liver biopsy but predominantly percutaneous or transvenous approaches are used. A wide choice of needles is available and the approach and type of needle used will depend on the clinical state of the patient and local expertise but, for non-lesional biopsies, a 16-gauge needle is recommended. Many patients with liver disease will have abnormal laboratory coagulation tests or receive anticoagulation or antiplatelet medication. A greater understanding of the changes in haemostasis in liver disease allows for a more rational, evidence-based approach to peri-biopsy management. Overall, liver biopsy is safe but there is a small morbidity and a very small mortality so patients must be fully counselled. The specimen must be of sufficient size for histopathological interpretation. Communication with the histopathologist, with access to relevant clinical information and the results of other investigations, is essential for the generation of a clinically useful report.

  • liver biopsy
  • histopathology
  • interventional radiology
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/gutjnl-2020-321299

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    Footnotes

    • Twitter @LiverTrust

    • Correction notice This article has been corrected since it published Online First. The last author's name has been corrected.

    • Contributors All authors have contributed and approved the mauscriipt.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement There are no data in this work