Comprehensive Literature Review on Liver Biopsy Methods and Analysis

This literature review examines various liver biopsy techniques used for histological examination of liver tissues. The review discusses the advantages and limitations of different methods, including percutaneous, transjugular, and laparoscopic biopsies, as well as computed tomography-guided techniques. The study highlights the importance of liver biopsy in diagnosing and managing liver diseases, such as allograft dysfunction, steatohepatitis, and chronic viral hepatitis. It analyzes the safety and efficacy of each technique, considering factors like invasiveness, cost, and specimen quality. The review emphasizes the significance of accurate diagnostic findings through a systematic approach, considering various anatomic structures for a meaningful diagnosis. The article also explores the clinical applications of liver biopsy, especially in cases of diagnostic uncertainty or space-occupying lesions, and discusses the associated complications and considerations for each method.

Running head: LITERATURE REVIEW ON LIVER BIOPSY 1
Literature Review on Liver Biopsy
Student’s name
Institutional affiliation

LITERATURE REVIEW ON LIVER BIOPSY 2
Literature Review on Liver Biopsy
Introduction
The human body is composed of extracellular materials and cells, which have been
produced by cells. Histology is the discipline focusing on the microscopic examination of the
human body components (Alturkistani, Tashkandi, & Mohammedsaleh, 2016). Through
histology, it is possible to understand the organization of human body organs and tissues. It
consists of broader aspects of microscopic anatomy. There are different methods that can be
used to examine structures of cells and tissue characteristics. Histological studies are
important in the autopsy, forensic investigations, education, and diagnosis (Black, 2012).
This article focuses on the literature review on the advantages and limitations of histology
technique used to examine the liver tissues.
Literature Review
Liver biopsy
Needle biopsy is an important histological technique used to examine liver tissue.
With this technique, studies have found that it is possible to manage liver diseases
(Aziaripour, Lagerweij, Scharfbilling, Jadczak, Willershausen, & Van Noorden, 2016). Liver
biopsy seems to be easier and safer to use as it involves the use of open and laparoscopic,
transjugular, and percutaneous biopsies (Suriawinata & Thung, 2015). Percutaneous allows
for the use of suction needle and cutting needle techniques in examining liver tissues. This
technique is least invasive, least costly and most common liver biopsy. In fact, suction needle
technique offers an adequate specimen for evaluating the histologic and related ancillary
studies (Liversupport.com, 2017). However, the complications leading to specimen outcome
can cause inadvertent biopsy of adjacent organs like intestine, pancreas, and kidney
(Suriawinata & Thung, 2015).

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Additionally, transjugular or transvenous is an important liver biopsy method. It
involves the use of catheter through the inferior vena cava, right vein, and internal jugular
vein (Suriawinata & Thung, 2015). The catheter technique provides a second-line procedure,
especially in patients suffering from coagulation disorders, gross ascites, fulminant hepatic
failure and severe obesity. Studies have indicated that transjugular technique poses
considerable costs, time, and effort (Suriawinata & Thung, 2015). Indeed, the percutaneous
biopsy is affordable technique compared to transjugular. This is because; it involves the use
of smaller fragmented specimens. Nonetheless, catheter technique allows for the use of better
needles thus improved the specimen quality (Liversupport.com, 2017). The complications
relating to this technique because of the multiple specimens include inadvertent biopsy,
contrast-related reaction, and arrhythmia.
Laparoscopic method of liver biopsy offers direct visualization of peritoneal and liver
cavity. The technique allows for the use of wedge and needle biopsy, as it involves the use of
larger specimen. The users of the technique have recognized the sensitivity of the chronic
liver diseases and cirrhosis like viral hepatitis, primary sclerosing cholangitis, and nodular
regenerative hyperplasia (Black, 2012). Conversely, laparoscopic bariatric surgery is viewed
as an expensive and invasive method. With this technology, Avwioro, Iyiola, and
Aghoghovwia explained that the risk of hemorrhage and anesthesia due to the invasive nature
of the method (Avwioro, Iyiola, & Aghoghovwia, 2010). Laparoscopic bariatric surgery is
popular for the obese patients thus increase the evaluation of intraoperative biopsies for
fibrosis and steatohepatitis.
Computed tomography has also been used as a liver biopsy technique. This
ultrasound-guided technique involves the use of fine-needle aspiration. The computed
tomography avoids the use of intersecting vessels and visualizes hepatic lesion (Suriawinata
& Thung, 2015). For cytologic or histologic diagnosis, it is possible to handle complex

LITERATURE REVIEW ON LIVER BIOPSY 4
anatomy cases based on the space-occupying lesion. Scholars have argued that multiple
aspirations ensure adequate specimen thus makes the interpretation achievable (Black, 2012).
Similarly, the cell block evident in the ultrasound-guided technique allows for the additional
staining and increase sensitivity (Suriawinata & Thung, 2015). However, controversial issues
have emerged regarding the computed tomography because it allows for the persistent of
malignant cells. Interestingly, this technique is beneficial to cirrhotic patients has it reduces
the hemorrhage risks compared with transcutaneous biopsy.
The liver biopsy has proved useful in evaluating patients with liver problems,
especially space-occupying lesion (Liversupport.com, 2017). This technique is critical for
patients with allograft dysfunction, steatohepatitis, and chronic viral hepatitis thus assesses
the level of liver damage. In most cases, where the clinical diagnosis generates doubt
regarding acute hepatitis, liver biopsy becomes critical. In fact, where there are multifactorial
causes of acute hepatitis or mistaken working diagnosis, the liver biopsy defines the situation
accurately (Ong, Gravante, Metcalfe, & Dennilson, 2013). Liver biopsy has proved to be
relatively safe despite being an invasive procedure.
Conclusion
The liver biopsy is an important histological examination technique that is based on
specific routine. The systematic approach ensures diagnostic findings are accurate. It
considers various anatomic structures of the tissue leading to a meaningful diagnosis.
Importantly, the article has focused on the liver biopsy techniques in examining the damages
and injuries on the liver tissues. It has analyzed the findings of different studies relating to the
histological techniques for examining liver tissue.

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Bibliography
Alturkistani, H. A., Tashkandi, F. M., & Mohammedsaleh, Z. M. (2016, March). Histological
Stains: A Literature Review and Case Study. Global Journal of Health Science, 8(3),
72-79.
Avwioro, G., Iyiola, S., & Aghoghovwia, B. (2010, August). Histological and Biochemical
Markers of the Liver of Wistar Rats on Subchronic Oral Administration of Green Tea.
North American Journal of Medical Sciences, 2(8), 376-380.
Aziaripour, A., Lagerweij, T., Scharfbilling, C., Jadczak, A. E., Willershausen, B., & Van
Noorden, C. J. (2016). A Survey of Clearing Techniques for 3D Imaging of Tissues
with Special Reference to Connective Tissue with Special Reference to Connective
Tissue. Progress in Histochemistry and Cytochemistry, 51(2), 9-23.
Black, J. (2012). Microbiology: Principles and exploration (8th ed.). New York: John Wiley
Sons.
Liversupport.com. (2017, April 10). The Advantages and Disadvantages of Liver Fibrosis
Evaluation Methods. Retrieved September 6, 2017, from Liversupport.com:
http://www.liversupport.com/comparing-liver-fibrosis-evaluation-methods/
Ong, S. L., Gravante, G., Metcalfe, M. S., & Dennilson, A. R. (2013, January 14). History,
Ethics, Advantages, and Limitations of Experimental Models for Hepatic Ablation.
World Journal of Gastroenterology, 19(2), 147-154.
Suriawinata, A. A., & Thung, S. N. (2015). Liver Tissue Processing and Normal Histology.
Retrieved September 5, 2017, from https://clinicalgate.com/liver-tissue-processing-
and-normal-histology/