Liver biopsy in children: position paper of the ESPGHAN Hepatology Committee.

Liver biopsy (LB) is still the criterion standard procedure for obtaining liver tissue for histopathological examination and a valuable tool in the diagnosis, prognosis, and management of many parenchymal liver diseases. The aim of this position paper is to summarise the present practice of paediatric LB and make recommendations about its performance. Although histological evaluation of the liver is important in assessing prognosis and exploring treatment, noninvasive techniques (ie, imaging, laboratory markers) may replace use of liver histology. The indications for LB are changing as present knowledge of aetiologies, pathomechanism, and therapeutic options in paediatric liver disease is evolving. Adult and paediatric literature was reviewed to assess the existing clinical practice of LB with focus on the technique, indications, risk of complications, and contraindications in paediatrics. This position paper presents types of LB, indications, complications, contraindications, and an essential checklist for paediatric LB.

Liver biopsy in children 2014: who, whom, what, when, where, why?

Liver biopsy is the standard procedure for obtaining hepatic tissue for histopathological examination. The three major techniques are percutaneous, transvenous, and laparoscopic/open biopsy, with either cutting or suction needles. The indications for liver biopsy are shifting as knowledge of etiologies, non-invasive biomarker alternatives, and treatment options in paediatric liver disease expand. This mini-review presents specific indications, alternative approaches, methods, complications, and contraindications for paediatric liver biopsy.