Transjugular liver biopsy in the nineties

Papatheodoridis, GV; Patch, D.; Watkinson, A; Dodge, G.; Burrhoughs, AK

doi:10.1016/s0168-8278(98)80788-5

Cited by 2 publications

(3 citation statements)

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“…Finally, percutaneous liver biopsy cannot be performed in subgroups of patients with liver diseases and specific contraindications, such as those with impaired hemostasis of any cause [3] . Although transjugular liver biopsy can be safely performed in most cases with contraindications to the percutaneous route, this approach is more time-consuming and expensive, it requires highly trained personnel and, most importantly, it is not available in all centers [24] .…”

Section: Risks and Limitations Of Liver Biopsymentioning

confidence: 99%

Ethics Related to Liver Biopsies and Antiviral Therapies in Chronic Viral Hepatitis

Papatheodoridis¹

2008

Dig Dis

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Ethics related to liver biopsies in patients with chronic viral hepatitis mainly include issues on the indications, potential risks and benefits and validity of available alternative options. Liver biopsy is the gold standard for the overall evaluation of liver lesions, but its indications are decreasing. It is not usually required for the correct etiological diagnosis but mostly for the appropriate classification in specific settings. It certainly estimates the severity of liver injury, which influences the prognosis and perhaps therapeutic decisions. It is generally a simple and safe but invasive procedure, which carries a small risk for complications, requires the patient’s admission for 12–24 h and may have sampling errors. New, rather accurate, noninvasive tests have been developed and their use may increase in the future, perhaps not for the initial evaluation but mostly for the long-term follow-up of such patients. Therapeutic options for chronic viral hepatitis have substantially improved over the last decade, but there are still several unsettled issues creating ethical dilemmas. Treating physicians should ideally have knowledge and personal experience on several aspects of the management of patients with chronic viral hepatitis, who should be adequately informed and participate in the decisions for liver biopsy and/or therapeutic intervention.

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Section: Risks and Limitations Of Liver Biopsymentioning

confidence: 99%

Ethics Related to Liver Biopsies and Antiviral Therapies in Chronic Viral Hepatitis

Papatheodoridis¹

2008

Dig Dis

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“…Given these background considerations, the real question raised by the investigators' work is not the necessity or otherwise of performing liver biopsies (which incidentally are safe by transjugular route in the transplantation setting 5 and would obviate many of the disavantages of a standard intercostal puncture), but whether one should strive by immunosuppression to achieve faster normalization of liver function test results. Too much immunosuppression would remove the window of opportunity for immunologic engagement, 6 as the investigators mentioned.…”

Section: To the Editorsmentioning

confidence: 99%

“…Criteria to treat histologically proven rejection in the face of an abnormal pattern of "normalizing liver function tests" need to be defined a priori. Greater use of transjugular liver biopsies will lessen the small complication rate of percutaneous biopsies 5 …”

Section: To the Editorsmentioning

confidence: 99%