Liver biopsy, known as liver biopsy, was first reported in 1883 and has gradually spread in the clinic after 4 innovations. The importance of liver biopsy is to obtain biopsied liver tissue at minimal cost of injury and to confirm the diagnosis after rigorous pathological examination, which is a gold standard for clinical diagnosis. At present, the diagnosis of clinical viral hepatitis is based on virological laboratory indices, serum biochemical tests, imaging examinations, clinical manifestations, and empirical diagnosis given by physicians after logical analysis. In the “Prevention and Control Program for Viral Hepatitis” (Trial) developed at the Xi’an Conference in 2000, liver inflammatory activity is classified into 5 levels and fibrosis into 5 levels, which is difficult to diagnose clearly by imaging and empirical diagnosis. Pathological examination not only improves the accuracy of diagnosis, but also provides a guiding basis for physicians to develop treatment plans. Therefore, liver tissue biopsy is recommended for patients with chronic hepatitis who have indications for liver biopsy. When is liver aspiration necessary? Liver aspiration is one of the most important methods for the routine diagnosis of liver disease. Liver puncture is called liver puncture biopsy, which means that a little liver tissue is removed from the liver for pathological examination. So, what exactly is the purpose of liver puncture and in which cases do patients need it? This is probably a question that most patients with liver disease are confused about, so we will introduce this knowledge to you one by one, hoping to provide you with some help. Differential diagnosis of difficult cases: Many chronic liver diseases with difficult clinical diagnosis, such as viral hepatitis, alcoholic hepatitis, hepatic tuberculosis, hepatic granuloma, schistosomiasis, fatty liver, primary biliary liver sclerosis and various metabolic liver diseases (such as hepatomegaly, hepatic glycogen accumulation disease, hepatic amyloidosis, etc.), often require liver puncture to understand the patient’s liver lesions, to provide a clear diagnosis It provides an important and even decisive basis for definitive diagnosis. Second, to understand the activity and developmental stage of chronic hepatitis lesions: There are many patients with chronic hepatitis B who have been infected with liver disease virus for a long time, but abnormal transaminases may be found in blood tests for only six months, and the level of liver disease virus content is not high. Such patients can find out whether the chronic liver disease is in an active stage by liver puncture and can infer the severity of their lesions. Third, to provide the pathogenic diagnosis of each type of viral hepatitis: there are still some viral hepatitis, and it is difficult to determine its etiology through clinical laboratory tests. For example, patients with hepatitis B may have all negative viral markers of liver disease, and virus detection can be performed on biopsies of the liver through liver puncture. Fourth, the detection of early, less active or still compensated cirrhosis: especially liver fibrosis, as long as it has not yet progressed to the end stage, it is generally difficult to detect through blood tests. In addition, some patients diagnosed as chronic asymptomatic liver disease virus carriers can sometimes be found to be active cirrhosis or chronic active hepatitis by liver aspiration. Fifth, the selection and application of antiviral drugs to determine the efficacy of indicators: currently commonly used anti-liver disease virus drugs are interferon and adefovir (currently two drugs have been marketed under the trade names of daidzein and hevelex), not only the course of treatment is long, and expensive. If liver puncture can be performed before treatment, according to the degree of inflammatory activity of liver tissue, selective application of antiviral drugs will significantly improve the efficacy. Sixth, as an indicator of chronic hepatitis: liver aspiration can detect the lesion of liver cells. In severe hepatitis, if hepatocellular edema is the main cause, the disease is mild, the prognosis is good, and the death rate is low; if hepatocellular necrosis is the main cause, and the residual rate of normal liver cells is low, the disease is severe, the prognosis is poor, and the death rate is high. It is important to note that the current technique of liver puncture is relatively mature. As long as the indications and contraindications are mastered, liver puncture is relatively safe. The significance of liver puncture for diagnosis suggests that the prognosis and treatment are completely different for different etiologies, so only with a clear diagnosis can a correct treatment plan be formulated for patients with liver disease, laying a good foundation for a smooth recovery.