A liver biopsy is a procedure in which a small needle is inserted into the liver to collect a tissue sample. The tissue is then analyzed in a laboratory to help doctors diagnose a variety of disorders and diseases in the liver.
Elastography is a noninvasive method to assess liver fibrosis by measuring liver stiffness. Studies have compared elas-tography to percutaneous biopsy. Laparoscopic biopsy is associated with decreased sampling error compared to percutaneous biopsy, as laparoscopic biopsies are obtained from both liver lobes and gross nodu-larity can be visualized.
All patients underwent diagnostic laparoscopy with liver biopsy by one experienced hepatologist, as we have previously described. Biopsy specimens were obtained from both the right and left hepatic lobes, using an automatic 16-gauge Tru-Cut needle (biopsy gun). In addition, the physician performing the procedure subjectively assessed the gross appearance of the liver by examining liver edge thickness, presence of nodularity, liver surface irregularity, firmness or heaviness when probed, fatty appearance, and hyperemia. The gross appearance of nodularity with firmness to probing was considered diagnostic of cirrhosis.