Guidelines on the use of liver biopsy in clinical practice. British Society of Gastroenterology.

1.0 Introduction Erlich is credited with the first liver aspiration in 1883 and subsequently the first percutaneous liver biopsy for diagnostic purposes was reported in 1923. The technique has been modified since then, and over the past 50 years it has become a central investigation of hepatic disease. The low mortality (0.01–0.17%) and the relatively low morbidity of this procedure have meant that liver biopsy has become widely used. Advances in medical technology and especially in imaging, together with advances in drug therapy have greatly influenced the diagnosis and management of hepatic disease and as a consequence the indications for liver biopsy are changing. In 1991 the British Society of Gastroenterology (BSG), together with the Royal College of Physicians of London, undertook a nationwide audit of percutaneous liver biopsy in 189 health districts. It is clear from this audit and from reviewing the literature that there continue to be significant diVerences in clinical practice with respect to liver biopsy across the United Kingdom, and a lack of standardised protocols between institutions. These guidelines examine the evidence for methods of liver biopsy in adults.