UNEXPLAINED INTRAHEPATIC CHOLESTASIS: ROLE AND DIAGNOSTIC YIELD OF LIVER BIOPSY

Intrahepatic cholestasis represents a complex challenge for gastroenterologists due to its broad range of potential causes. Establishing an accurate diagnosis often requires extensive investigations and sophisticated tests, which are, in most cases, costly. Liver biopsy (LB) becomes necessary when noninvasive examinations fail to reveal an etiology.The aim of our study was to assess the diagnostic yield of LB in identifying the underlying causes of unexplained intrahepatic cholestasis.

Materials and Methods:We performed a retrospective descriptive study in the Department of Hepato-Gastroenterology at Hassan II University Hospital, Fez, Morocco, from January 1, 2017, to August 1, 2023. It included patients with chronic intrahepatic cholestasis lasting more than six months and with inconclusive initial workup (negative toxicology, normal ultrasound, negative viral serologies, and negative autoimmune markers) who underwent ultrasound-guided percutaneous liver biopsy. Data on demographics, clinical features, laboratory parameters, and histopathological findings were collected from medical records. Inconclusive cases were reviewed by a senior pathologist, and some underwent a second biopsy. Analysis was descriptive, reporting means, ranges, numbers, and percentages.