Liver biopsy in ambulatory patients. Diagnostic value in comparison to conventional and quantitative liver function tests

In this retrospective analysis we investigated the diagnostic yield of 148 consecutive liver biopsies performed as an outpatient procedure. In 144 patients, adequate specimens for histologic analysis were obtained. In these patients, 226 diagnoses were entertained. Clinical diagnosis was confirmed in 49.3%, modified in 43.8% and altered in 6.9%. Liver biopsy was particularly helpful in patients where an alcoholic etiology was suspected, since this could be confirmed in only 59.4% while in the others different, often treatable, causes of chronic liver disease were found. Neither conventional nor quantitative liver tests (galactose elimination capacity, aminopyrine breath test) served to differentiate reliably between severe and mild lesions. We conclude that liver biopsy remains an important diagnostic tool in patients with chronic liver disease, and that it can be safely performed on an outpatient basis in appropriately selected patients.