Changing Trends in Liver Biopsy Practices: A Single-Center Analysis

Area of Science:

• Hepatology
• Gastroenterology
• Pathology

Background:

• Liver biopsy (LB) remains a crucial diagnostic tool for liver diseases.
• Understanding trends in LB indications, techniques, and diagnoses is essential for clinical practice.
• Previous studies highlight the evolution of diagnostic modalities in hepatology.

Purpose of the Study:

• To evaluate changes in liver biopsy (LB) indications, techniques, and histopathologic diagnoses over a decade.
• To compare current LB practices with those from 10 years prior.
• To identify shifts in the most common reasons for and outcomes of liver biopsies.

Main Methods:

• Retrospective analysis of parenchymal liver biopsies (LB) from two one-year periods, separated by 10 years.
• Data extracted from a pathology database, comparing 427 recent biopsies (2017-2018) with 166 older biopsies.
• Statistical comparison of indications, biopsy routes, diagnoses, and adverse events between the two groups.

Main Results:

• Elevated liver enzymes were the most frequent indication for LB in both periods.
• Non-alcoholic fatty liver disease (NAFLD) is now the leading diagnosis, surpassing viral hepatitis from a decade ago.
• Endoscopic ultrasound-guided liver biopsy (EUS-LB) increased significantly (80.3% vs. 0%), while CT-guided and percutaneous approaches decreased.

Conclusions:

• Significant evolution in liver biopsy (LB) practice patterns observed over 10 years.
• Increased overall LB volume and a notable shift towards EUS-guided procedures.
• NAFLD has emerged as the predominant diagnosis necessitating liver biopsy.