Nowadays, many patients with chronic liver disease encounter the problem that the hospital doctor recommends a liver puncture test during their visit. So why do liver disease patients need a liver puncture? What are the benefits of this test? Is it safe? The following is a brief introduction to these patient concerns. Why do I need a liver puncture? Most people think that the liver is a solid organ and it is scary to think about having a doctor puncture it with a needle. So, many patients do not do it if they can, hoping to use other tests instead. In general, many patients with liver disease can be diagnosed after history taking and physical examination, or when supplemented with the necessary laboratory and imaging tests. However, some diseases cannot be diagnosed definitively and can only be concluded with a liver aspiration biopsy and pathology. There are also some diseases that are difficult to diagnose and require a combination of liver biopsy and clinical symptoms to make a diagnosis. In addition to a definitive diagnosis, liver aspiration biopsy can provide direction for further investigation of some diseases. Examples include hemochromatosis and hepatomegaly, where liver puncture biopsy is followed by histochemical staining for specific staining. In addition, liver puncture biopsy can also provide indicators for grading and staging of chronic liver diseases, which can be useful for guiding the treatment of chronic liver diseases. Second, is liver aspiration safe? Knowing that liver puncture biopsy is so important, some patients still worry: is it safe? In recent years, due to the improvement of puncture instruments and operation methods, and the development of strict indications and contraindications, percutaneous liver puncture biopsy can obtain better specimens and is quite safe. In addition, in order to ensure the safety of the examination, the doctor will perform liver biochemistry, coagulation tests, blood routine and abdominal ultrasound examination on the patient before the operation, to locate the puncture site with ultrasound and to know whether there are larger blood vessels or enlarged gallbladder around, and to routinely give preoperative measures such as intramuscular injection of vitamin K1. And explain to the patient the precautions to cooperate with the puncture, practice air delivery as well as eliminate the patient’s fear and nervousness. After hepatic puncture, blood pressure and pulse were closely monitored, and the patient was placed in bed for postoperative observation. The incidence of bleeding after liver puncture is about 1 in 100,000. Since the technique of liver biopsy is very mature, as long as the indications and contraindications are well mastered and adequate preparation is made before liver puncture, the operation of liver puncture biopsy can be done without any problems. Third, what is the clinical significance of liver puncture? 1. It is beneficial to the differential diagnosis of various liver diseases. Many chronic liver diseases that are difficult to diagnose clinically, such as various types of viral hepatitis, alcoholic hepatitis, liver tuberculosis, liver granuloma, schistosomiasis, liver tumors, fatty liver, liver abscess, primary biliary liver sclerosis and various metabolic liver diseases (hepatomegaly, hepatic glycogen accumulation disease, hepatic amyloidosis), etc., often require liver puncture to understand the patient’s liver lesions and provide an important It may even be a decisive basis. 2. To understand the extent and activity of liver lesions. Liver aspiration biopsy is an examination method that can directly understand the pathological changes of liver tissue and can make a more objective and precise diagnosis. There are many patients with chronic hepatitis B who have been infected with the liver disease virus for a long time, but may not have been found to have abnormal transaminases for long and have low viral levels. Such patients can find out whether the chronic liver disease is in active stage by liver puncture and can infer the severity of their lesions. 3.Provide pathogenetic diagnosis of each type of viral hepatitis. There are still some viral hepatitis where clinical tests show that all serum viral markers of liver disease are negative, making it difficult to determine their etiology. However, hepatitis viruses in liver tissue can be detected by liver puncture with ultrasensitive immunohistochemistry and in situ molecular hybridization techniques. 4.Discovery of early, quiescent or still compensated cirrhosis. In the early stage of liver disease onset, it is usually difficult to detect the presence of cirrhosis in patients through blood tests and ultrasound examinations. However, through liver aspiration examination, it is possible to make an accurate diagnosis of liver fibrosis and early, quiescent or still compensated cirrhosis, and to identify the clinical type of cirrhosis, distinguish whether it is alcoholic cirrhosis, or post-hepatitis cirrhosis, and whether it is accompanied by active hepatitis. 5.It is beneficial to the selection of drugs and the judgment of drug efficacy. Histopathological changes in liver biopsy before and after treatment are reliable indicators for judging the effect of drug therapy, providing an objective evaluation basis for clinical drug therapy. At present, the commonly used anti-liver disease virus drugs are interferon and nucleoside (acid) analog lamivudine, for antiviral treatment, 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 and targeted application of antiviral drugs, will significantly improve the efficacy. 6. Identify the nature and cause of jaundice. Some clinical jaundice is often difficult to determine the cause, and liver biopsy can be performed. It can determine whether the jaundice is due to impaired bilirubin metabolism, or hepatocellular jaundice, or cholestasis, viral or drug-induced. The prognosis and treatment are completely different for different etiologies, and only with a clear diagnosis can the correct treatment plan be formulated. 7, as a judge of chronic hepatitis condition and prognosis. Liver puncture can discover the lesion of liver tissue, providing an objective basis for the judgment of disease change and prognosis. If severe hepatitis is mainly hepatocellular edema, the condition is mild, the prognosis is better and the death rate is lower; if hepatocellular necrosis is the main cause and the residual rate of normal liver cells is low, the condition is serious, the prognosis is poor and the death rate is high. 8. Diagnostic treatment is possible. Under the guidance of B ultrasound or CT, purposeful liver puncture can be carried out for liver abscess puncture and pus drainage, drug injection, anhydrous alcohol intratumoral injection for liver cancer, etc. Therefore, combined with our clinical practice for many years, liver puncture tissue biopsy is of great benefit in clarifying the etiology and pathology of patients, formulating treatment plans and judging prognosis.