A comparison of two audits on liver biopsies carried out in a tertiary care setting

Introduction and objectives: The emergence of less invasive, more sophisticated techniques to evaluate the liver has led to a belief that liver biopsies (LB) will be performed in lesser numbers in the future. However, in our setting with limited advanced technology, liver biopsies are still performed in considerable numbers. The aim of this study was to carry out an audit of LBs performed during a three-year period and compare this with a similar audit done previously.
Methodology: A retrospective descriptive study was done on all LBs reported from 2019 to 2022 at the Department of Pathology, Faculty of Medicine, University of Kelaniya. Data were collected regarding the number, demographic factors of patients undergoing LB and diagnoses, and these were compared with a similar audit done in the same unit from 2009 to 2012.
Results: A total of 327 LBs were performed, in comparison to 216 in the previous audit, an increase of 51.3%. The age range was two months to 78 years, which included 165 males (50.4%) and 162 (49.6%) females. Most LBs (21%;69/327) were done in the 51-60-year age group compared to the previous audit where 21% of LBs were done in the 61–70-year age group. The common histological diagnoses were focal lesions (24%;77/327), cirrhosis (57/327,17%), fatty liver disease (50/327,15%) and chronic hepatitis (39/327,12%). Diagnoses were similar, except that transplant biopsies accounted for 6.1% (20/327) and cholestasis for 9.1% (30/327), in comparison to none and 6.1% (13/216) in the earlier audit.
Discussion and conclusion: The number of LBs performed has increased during the 10-year period with some variations in demographic factors and diagnostic entities and the addition of transplant biopsies. These findings support the view that liver biopsies are still performed in considerable numbers even though there are more sophisticated techniques.