ON WORLD HEPATITIS DAY 28TH JULY 2014
INDIA’S LARGEST STUDY ON DIAGNOSIS OF ADVANCED LIVER DISEASE WITHOUT LIVER BIOPSY
ACCEPTED FOR PUBLICATION IN INDIAN JOURNAL OF GASTROENTEROLOGY
In a study conducted at department of gastroenterology , Sir Ganga Ram Hospital on 175 patients from 2012 to 2013 has convincingly proved the utility of non-invasive assessment of stiffness of liver by a recent technique called Fibroscan .
It is well known that in a significant proportion of Indian patients who are overweight , drink alcohol , have Hepatitis-B or Hepatitis –C or fatty liver disease may ultimately develop end stage liver disease called liver cirrhosis with all its complications . Unfortunately , the specific symptoms of liver cirrhosis like jaundice , swelling of the feet or blood vomiting are peculiarly absent till the very late stage of the disease which is liver cirrhosis . Hence , there is an urgent need for early diagnosis .
Till recently , the gold standard for this diagnosis of liver cirrhosis was biopsy of the liver , which is an invasive procedure with associated complications . More over the cost of liver biopsy is about Rs 10-15000 and needs day care observation.
Fibroscan , which is a novel technique has been recently introduced in India for non-invasive assessment of stiffness of liver , thereby obviating the need of invasive liver biopsy . This is not only cheaper but also quicker and is equally accurate in diagnosis of liver fibrosis (stiffness) .
But uptill now , there was no large scale study on Indian patients authenticating the effectiveness of Fibroscan with Liver Biopsy . Our study has found that Fibroscan in comparison to liver biopsy can predict liver fibrosis with 90 % accuracy in early as well as late stages of liver disease at 1/3rd of the cost .
According to Dr Anil Arora , Chairperson , Department of Gastroenterology , Sir Ganga Ram Hospital , “ In our study , we found that Fibroscan is a safe , quick and cost-effective technique of diagnosing stage of liver disease . In coming days , this will be of immense use in large number of patients who are obese, drink alcohol ,and in patients with Hepatitis -B or Hepatitis –C or fatty liver disease . It will help us immensely in diagnosis of status of liver and start of treatment before fatal complications set in .The best part is that it can be repeated frequently to assess the stage of disease before and after treatment . This was not possible in liver biopsy ”.
According to Dr Praveen Sharma , Consultant , Department of Gastroenterology , Sir Ganga Ram Hospital , “ Our study has opened new pathway in treatment of patients of liver disease . Fibroscan can obviate the need of liver biopsy in more than 90 % of the patients as it can make the same diagnosis at 1/3rd of the cost , and without any complications .”
According to Dr Pankaj Tyagi , Consultant , Department of Gastroenterology , Sir Ganga Ram Hospital , “ Our hospital has an extra large probe called XL Probe for Obese individuals who are at high risk of development of fatty liver disease related liver cirrhosis .As in this group of patients conventional fibroscan probe is not reliable .”
Advantages of Fibroscan with Liver Biopsy
FIBROSCAN LIVER BIOPSY
1 Non-invasive procedure Invasive procedure
2 No complications Associated with complications like bleeding etc
3 Done in 5 minutes in OPD Takes 15-20 minutes with hospitilization
4 Can be repeated any number of times Difficult to repeat
5 Cost is approx Rs 3500-5000 Cost is approx Rs 10-15000
Dr Anil Arora ,author of the study &
Chairman , Department of Gastroenterology
Sir Ganga Ram Hospital
For more information on the study visit the link below