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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="review-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Journal of Clinical Practice</journal-id><journal-title-group><journal-title xml:lang="en">Journal of Clinical Practice</journal-title><trans-title-group xml:lang="ru"><trans-title>Клиническая практика</trans-title></trans-title-group></journal-title-group><issn publication-format="print">2220-3095</issn><issn publication-format="electronic">2618-8627</issn><publisher><publisher-name xml:lang="en">Eco-Vector</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">699338</article-id><article-id pub-id-type="doi">10.17816/clinpract699338</article-id><article-id pub-id-type="edn">KQRANB</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>Reviews</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>Научные обзоры</subject></subj-group><subj-group subj-group-type="article-type"><subject>Review Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">Liver biopsy in modern clinical practice: indications, methods and safety</article-title><trans-title-group xml:lang="ru"><trans-title>Биопсия печени в современной клинической практике: показания, методы и безопасность</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0730-5993</contrib-id><contrib-id contrib-id-type="spin">7517-5590</contrib-id><name-alternatives><name xml:lang="en"><surname>Zinovskiy</surname><given-names>Mikhail V.</given-names></name><name xml:lang="ru"><surname>Зиновский</surname><given-names>Михаил Вячеславович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>mishandrix@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0045-2715</contrib-id><contrib-id contrib-id-type="spin">1577-0901</contrib-id><name-alternatives><name xml:lang="en"><surname>Keshvedinova</surname><given-names>Aishe A.</given-names></name><name xml:lang="ru"><surname>Кешвединова</surname><given-names>Айше Абляйевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>aishe1998@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8776-944X</contrib-id><contrib-id contrib-id-type="spin">6203-5870</contrib-id><name-alternatives><name xml:lang="en"><surname>Astakhov</surname><given-names>Dmitriy A.</given-names></name><name xml:lang="ru"><surname>Астахов</surname><given-names>Дмитрий Анатольевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, PhD</p></bio><bio xml:lang="ru"><p>канд. мед. наук</p></bio><email>astakhovd@mail.ru</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8539-4392</contrib-id><contrib-id contrib-id-type="spin">4316-4651</contrib-id><name-alternatives><name xml:lang="en"><surname>Panchenkov</surname><given-names>Dmitriy N.</given-names></name><name xml:lang="ru"><surname>Панченков</surname><given-names>Дмитрий Николаевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, PhD, Professor</p></bio><bio xml:lang="ru"><p>д-р мед. наук, профессор</p></bio><email>dnpanchenkov@mail.ru</email><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff2"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies</institution></aff><aff><institution xml:lang="ru">Федеральный научно-клинический центр специализированных видов медицинской помощи и медицинских технологий</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">Russian University of Medicine</institution></aff><aff><institution xml:lang="ru">Российский университет медицины</institution></aff></aff-alternatives><pub-date date-type="preprint" iso-8601-date="2026-06-13" publication-format="electronic"><day>13</day><month>06</month><year>2026</year></pub-date><pub-date date-type="pub" iso-8601-date="2026-08-06" publication-format="electronic"><day>06</day><month>08</month><year>2026</year></pub-date><volume>17</volume><issue>2</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>115</fpage><lpage>124</lpage><history><date date-type="received" iso-8601-date="2025-12-25"><day>25</day><month>12</month><year>2025</year></date><date date-type="accepted" iso-8601-date="2026-02-26"><day>26</day><month>02</month><year>2026</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2026, Eco-Vector</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2026, Эко-Вектор</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="en">Eco-Vector</copyright-holder><copyright-holder xml:lang="ru">Эко-Вектор</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by-nc-nd/4.0</ali:license_ref></license></permissions><self-uri xlink:href="https://clinpractice.ru/clinpractice/article/view/699338">https://clinpractice.ru/clinpractice/article/view/699338</self-uri><abstract xml:lang="en"><p>Despite the widespread availability of serological tests and radiological imaging modalities, liver biopsy remains a commonly performed procedure employed in the diagnosis, prognostic assessment, and determination of further patient management strategies. The principal indications for biopsy include focal hepatic lesions of undetermined etiology, diffuse liver diseases, unexplained elevation of hepatic enzymes, and suspected transplant organ rejection; the main contraindications are thrombocytopenia, hypocoagulation, and ascites. Owing to technological advances and the availability of multiple biopsy techniques, all established contraindications have become relative in nature, while complication and mortality rates remain low. Traditionally, liver biopsy was performed using the blind percutaneous technique or under ultrasound guidance. Alternative methods now exist that allow adequate tissue sampling with a significantly reduced complication profile. Transluminal endoscopic procedures (natural orifice transluminal endoscopic surgery, NOTES) and robotic technologies represent promising avenues for further development; however, their widespread integration into clinical practice requires additional investigation. This literature review addresses the indications and contraindications for the procedure, the types of liver biopsy, their associated complications, and the principal strategies for enhancing procedural safety.</p></abstract><trans-abstract xml:lang="ru"><p>Несмотря на доступность серологических тестов и рентгенологических методов обследования, биопсия печени является распространённой процедурой и применяется в рамках диагностики, оценки прогноза и определения тактики дальнейшего ведения пациента. Основными показаниями к биопсии являются очаговые образования печени неуточнённого генеза, диффузные заболевания, необъяснимое повышение уровня печёночных ферментов, а также подозрение на отторжение трансплантированного органа; основными противопоказаниями — тромбоцитопения, гипокоагуляция, асцит. Благодаря техническому прогрессу и возможности выбора нескольких видов биопсии все известные противопоказания стали иметь относительный характер, при этом частота осложнений и смертности стала невысокой. Традиционно биопсию печени проводили слепым чрескожным методом или под ультразвуковым контролем. В настоящее время существуют альтернативные методики, позволяющие получить образец тканей достаточного объёма при значимо меньшем количестве осложнений. Перспективными направлениями для дальнейшего развития являются транслюминальные эндоскопические вмешательства (NOTES) и использование роботизированных технологий, однако их широкое внедрение в клиническую практику требует дополнительных исследований. В настоящем обзоре литературы рассматриваются показания и противопоказания к процедуре, виды биопсий печени, их осложнения и основные векторы улучшения безопасности процедуры.</p></trans-abstract><kwd-group xml:lang="en"><kwd>liver biopsy</kwd><kwd>percutaneous liver biopsy</kwd><kwd>transvenous liver biopsy</kwd><kwd>transjugular liver biopsy</kwd><kwd>transfemoral liver biopsy</kwd><kwd>laparoscopic liver biopsy</kwd><kwd>endoscopic liver biopsy</kwd><kwd>robotic technologies</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>биопсия печени</kwd><kwd>чрескожная биопсия печени</kwd><kwd>трансвенозная биопсия печени</kwd><kwd>трансъюгулярная биопсия печени</kwd><kwd>трансфеморальная биопсия печени</kwd><kwd>лапароскопическая биопсия печени</kwd><kwd>эндоскопическая биопсия печени</kwd><kwd>роботизированные технологии</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Khalifa A, Rockey DC. 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