Asian-Pacific Association for the Study of the Liver (APASL) consensus guidelines on invasive and non-invasive assessment of hepatic fibrosis: a 2016 update
| Autor: | Jidong Jia, Gamal Shiha, Ashraf Omar, David Bernstien, Hamsik GHaziuan, Seng Gee Lim, Hitushi Maruyama, Ahmed Abdallah, Jose D. Sollano, Ahmed Ihab, Alaa Ibrahim, Ashok Kumar, Tarek Hassanein, Bahaa Abbas, Saeed Hamid, Amany AbdelMaqsod, Barjesh Chander Sharma, Masao Omata, Mamun Elmahatab, Diana A. Payawal, Pierre Bedossa, Yogesh Chawla, Ahmed Helmy, Manoj Kumar, Zaigham Abbas, Nizar N. Zein, Laurentius A. Lesmana, Abdelhamid Serwah, Shiv Kumar Sarin, Abdelkhalek Hamed, Aly Elsayed, Puja Sakhuja, Vivek A. Saraswat |
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| Rok vydání: | 2016 |
| Předmět: |
Liver Cirrhosis
medicine.medical_specialty Pathology Cirrhosis Consensus Portal venous pressure Biopsy Cost-Benefit Analysis 03 medical and health sciences 0302 clinical medicine Fibrosis Internal medicine medicine Humans Intensive care medicine Observer Variation Hepatology medicine.diagnostic_test business.industry Gold standard Evidence-based medicine medicine.disease 030220 oncology & carcinogenesis Liver biopsy Practice Guidelines as Topic Elasticity Imaging Techniques 030211 gastroenterology & hepatology business Hepatic fibrosis |
| Zdroj: | Hepatology international. 11(1) |
| ISSN: | 1936-0541 |
| Popis: | Hepatic fibrosis is a common pathway leading to liver cirrhosis, which is the end result of any injury to the liver. Accurate assessment of the degree of fibrosis is important clinically, especially when treatments aimed at reversing fibrosis are being evolved. Despite the fact that liver biopsy (LB) has been considered the "gold standard" of assessment of hepatic fibrosis, LB is not favored by patients or physicians owing to its invasiveness, limitations, sampling errors, etc. Therefore, many alternative approaches to assess liver fibrosis are gaining more popularity and have assumed great importance, and many data on such approaches are being generated. The Asian Pacific Association for the Study of the Liver (APASL) set up a working party on liver fibrosis in 2007, with a mandate to develop consensus guidelines on various aspects of liver fibrosis relevant to disease patterns and clinical practice in the Asia-Pacific region. The first consensus guidelines of the APASL recommendations on hepatic fibrosis were published in 2009. Due to advances in the field, we present herein the APASL 2016 updated version on invasive and non-invasive assessment of hepatic fibrosis. The process for the development of these consensus guidelines involved review of all available published literature by a core group of experts who subsequently proposed consensus statements followed by discussion of the contentious issues and unanimous approval of the consensus statements. The Oxford System of the evidence-based approach was adopted for developing the consensus statements using the level of evidence from one (highest) to five (lowest) and grade of recommendation from A (strongest) to D (weakest). The topics covered in the guidelines include invasive methods (LB and hepatic venous pressure gradient measurements), blood tests, conventional radiological methods, elastography techniques and cost-effectiveness of hepatic fibrosis assessment methods, in addition to fibrosis assessment in special and rare situations. |
| Databáze: | OpenAIRE |
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