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Occasionally, liver biopsy is required to monitor the progress of treatment, such as in chronic viral hepatitis. [1] It is an effective way to measure changes in the Ishak fibrosis score. [3] For the last century liver biopsy has been considered as the gold standard for assessing the stage and the grade of chronic liver disease.
Cholecystostomy is a medical procedure and carries its share of complications and adverse effects. Complications occur in approximately 10% of cases. [ 7 ] The most common issues encountered are catheter dislodgement, blockage, or a bile leak, which, while frequent, are considered minor complications. [ 10 ]
Some uses for this procedure includes: drainage of bile/infected bile to relieve obstructive jaundice, to place a stent to dilate a stricture in the biliary system, stone removal, and rendezvous technique [4] where guidewire from the common bile duct (CBD) meets with duodenoscope (coming from the oesophagus into the stomach and then duodenum) at the major duodenal papilla.
The gold standard for diagnosis of cirrhosis is a liver biopsy. This is usually carried out as a fine-needle approach, through the skin (percutaneous), or internal jugular vein (transjugular). [91] Endoscopic ultrasound-guided liver biopsy (EUS), using the percutaneous or transjugular route, has become a good alternative to use.
The diagnosis of portal hypertensive gastropathy is usually made on endoscopy. The usual appearance of portal hypertensive gastropathy on endoscopy is a mosaic-like or reticular pattern in the mucosa. Red spots may or may not be present. The pattern is usually seen throughout the stomach. [2]
Endoscopic retrograde cholangiopancreatography (ERCP) is a technique that combines the use of endoscopy and fluoroscopy to diagnose and treat certain problems of the biliary or pancreatic ductal systems. It is primarily performed by highly skilled and specialty trained gastroenterologists.
The choice for medical treatment should be based on the individual's severity of symptoms, quantitative elevation of liver enzymes and antibody levels, findings on liver biopsy, and ability to tolerate side effects of medical therapy.
liver biopsy consistent with PSC (if available) Historically, a cholangiogram would be obtained via endoscopic retrograde cholangiopancreatography (ERCP), which typically reveals "beading" (alternating strictures and dilation) of the bile ducts inside and/or outside the liver.