Liver biopsy and laparoscopy in hepatology [Leberbiopsie und Laparoskopie in der Hepatologie]

Percutaneous liver biopsy and laparoscopy are important and established methods for generating a histology specimen of the liver. Furthermore, laparoscopy allows the macroscopic evaluation of the liver surface and peritoneal cavity. Despite the improving indirect methods for imaging and measuring fibrosis, histology and laparoscopic evaluation of the liver remain indispensable for the diagnostic assessment of a variety of liver diseases. In unclear liver diseases, they yield important evidence for the differential diagnosis. In chronic liver disease, they contribute the essential information with respect to inflammatory activity (grading) and fibrosis content (staging), which is necessary for planning and executing any specific hepatological therapy. In the diagnosis of liver cirrhosis, laparoscopy must be considered the gold standard. The smallest focal lesions can be reliably detected and targeted by laparoscopic biopsy. This is why laparoscopy, in addition to its importance in hepatology, also has a significant role in the staging of some gastrointestinal tumors. Furthermore, laparoscopy and laparoscopic biopsy minimize the risk of bleeding after biopsy, since bleeding after organ puncture can be actively terminated. Therefore, laparoscopy allows safe liver biopsy even in patients with existing risk factors. © 2009 Springer Medizin Verlag.