Hepatic fibrosis is an integral stage in the progression of chronic liver disease, ultimately leading to cirrhosis and hepatocellular carcinoma (HCC). Globally, alcohol consumption, hepatitis B, and hepatitis C (HCV) have been the main causes of cirrhosis. Recently, the increasing prevalence of obesity and the metabolic syndrome has resulted in an increasing incidence of cirrhosis secondary to non-alcoholic fatty liver disease (NAFLD) in both developed and developing countries. Chronic liver disease and cirrhosis are important causes of morbidity and mortality throughout the world. Moreover, the burden of chronic liver disease is predicted to increase, attributed in part to increasing prevalence of end-stage liver disease and HCC secondary to NAFLD and HCV. Liver biopsies are most commonly used to determine the stage of fibrosis. Unfortunately, liver biopsy is an invasive procedure with a small but significant risk of morbidity and mortality. Pain and hypotension are the most frequent complications of the procedure. Intraperitoneal bleeding is considered the most serious complication. The mortality rate is about 1 in 10,000. For these reasons, patients may reject the procedure, there by leaving their possible fibrosis undiagnosed. Furthermore, the accuracy of liver biopsy in assessing fibrosis has come into question because of sampling error and intra and inter-boserver variability, which can lead to the over or under-estimation of the stage of fibrosis.
2011-07-14 | 262 visitas | Evalua este artículo 0 valoraciones
Vol. 8 Núm.2. Abril-Junio 2009 Pags. 148-149 Ann Hepatol 2009; 8(2)