Biopsy evaluation of chronic active hepatitis: Peritoneoscopy with directed liver biopsy versus blind percutaneous liver biopsy

Dale H. Wytock, Terrence W. Coleman, John R. Sharp, Charles E. Brady, Jeffrey A. Baybick, James W. Bagnall

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

In this prospective study of chronic active liver disease, we compared the assessment of hepatic histology in samples obtained by peritoneoscopy with directed liver biopsy and blind percutaneous liver biopsy in 23 cases (22 patients, one patient studied twice). In blinded fashion, a pathologist assessed all specimens for evidence of cirrhosis and degree of necroin-flammatory change. Two clinicians independently reviewed clinical and laboratory findings in both sets of biopsies. Each committed in writing recommendations regarding immunosuppressive therapy, follow-up intrval, and rebiopsy date. The final diagnosis differed from that made by percutancous and directed biopsy in 2 of 23 (9%) and 1 of 23 (4%) cases, respectively. Six cases of cirrhosis were correctly diagnosed by both biopsy methods, but only four of the six cirrhotic cases were diagnosed by gross peritoneoscopic findings. In only 2 of 23 (9%) cases was there disagreement in the degree of necroinflammatory change between the blind and directed biopsies that affected treatment recommendations. We conclude that blind percutaneous biopsy adequately diagnoses and monitors activity in viral chronic hepatitis for treatment purposes.

Original languageEnglish (US)
Pages (from-to)320-323
Number of pages4
JournalJournal of Clinical Gastroenterology
Volume10
Issue number3
DOIs
StatePublished - Jun 1988

Keywords

  • Chronic hepatitis
  • Liver biopsy
  • Peritoneoscopy

ASJC Scopus subject areas

  • Gastroenterology

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