An international multidisciplinary consensus statement on laparoscopic liver biopsy

Laparoscopic liver biopsy (LLB) provides a way to obtain liver tissue samples under direct visual inspection of the liver surface. It complements percutaneous liver biopsy (PLB) for complex or high-risk cases where PLB cannot be performed. Clinical practices for LLB vary across centers due to the lack of international standards. To improve the procedural quality and diagnostic efficiency of LLB, a multidisciplinary panel of 45 international experts from 6 continents, including hepatology, hepatobiliary surgery, gastrointestinal surgery, and metabolic and bariatric surgery, developed this consensus statement through three rounds of a modified Delphi process. This consensus covers clinical application scenarios, high-risk clinical scenarios, preoperative preparation, surgical procedures, complication management, and discharge and quality management. It aims to promote the standardization, safety, and rational clinical application of LLB; support the management of complex cases; and facilitate the appropriate implementation of this important diagnostic procedure.