3. Liver Biopsy and Laparoscopy

  1. Eugene R. Schiff MD, MACP, FRCP4,
  2. Willis C. Maddrey MD, MACP, FRCP5 and
  3. Michael F. Sorrell MD, FACP6
  1. Alyson N. Fox MD, MSCE1,
  2. Lennox J. Jeffers MD2 and
  3. Rajender Reddy MD, FACP, FACG, FRCP3

Published Online: 31 OCT 2011

DOI: 10.1002/9781119950509.ch3

Schiff's Diseases of the Liver, Eleventh Edition

Schiff's Diseases of the Liver, Eleventh Edition

How to Cite

Fox, A. N., Jeffers, L. J. and Reddy, R. (2011) Liver Biopsy and Laparoscopy, in Schiff's Diseases of the Liver, Eleventh Edition (eds E. R. Schiff, W. C. Maddrey and M. F. Sorrell), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781119950509.ch3

Editor Information

  1. 4

    Center for Liver Diseases and Schiff Liver Institute, University of Miami Miller School of Medicine, Miami, FL, USA

  2. 5

    Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA

  3. 6

    University of Nebraska College of Medicine, Omaha, NE, USA

Author Information

  1. 1

    Division of Gastroenterology, University of California, San Francisco, CA, USA

  2. 2

    Center for Liver Diseases, Miami, FL, USA

  3. 3

    Division of Gastroenterology, University of Pennsylvania, Philadelphia, PA, USA

Publication History

  1. Published Online: 31 OCT 2011
  2. Published Print: 9 DEC 2011

ISBN Information

Print ISBN: 9780470654682

Online ISBN: 9781119950509



  • Percutaneous liver biopsy;
  • transjugular liver biopsy;
  • laparoscopy


Since its introduction into clinical practice in the 1800s, liver biopsy has served as an invaluable tool in the evaluation and management of liver diseases. Over the years, the technique of percutaneous liver biopsy has been refined and has proven to be safe, with low rates of reported complications. A transjugular approach to liver biopsy should be used in those with contraindications to percutaneous liver biopsy. An added benefit of the transjugular liver biopsy is the ability to measure the portosystemic pressure gradient. Although less frequently done, laparoscopy is a safe and useful tool in the diagnosis of liver disease and can be used to observe the gross appearance of the liver, perform targeted biopsies, and obtain peritoneal samples. Despite the fact that there are several noninvasive techniques under evaluation for the diagnosis and management of liver disease, tissue sampling by percutaneous, transjugular, or laparoscopic approaches is unlikely to fall by the wayside in the near future.