Limitations of liver biopsy include Sampling error Occasional errors or uncertainty in cases of cholestasis Need for a skilled histopathologist Contraindications Absolute contraindications to liver biopsy include Patient's inability to remain still and to maintain brief expiration for the procedure Suspected vascular lesion (eg, hemangioma) Altered coagulation / hemostasis status Severe hypofibrinogenemia (as in the case of disseminated intravascular coagulation [DIC]) Determination of the procedural-related bleeding risk is complex and should be individualized, as classical markers of hemostasis (platelet count, international normalized ratio [INR]) have been shown to inaccurately predict bleeding tendency in patients with advanced liver disease.