Hepatology is a branch of gastroenterology and internal medicine. It deals with diseases of the liver, bile ducts and gallbladder.
Important liver diseases are Gallbladder cancer, gallstones, hepatitis, liver cancer, liver metastases and liver cirrhosis. Laboratory tests, sonography and other imaging examinations are important components of the diagnosis. The therapeutic options depend on the type and severity of the liver disease.
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Hepatology - liver - Further information
What is hepatology?
Hepatology is a medical specialty that deals with pathological and abnormal processes and conditions of the liver and bile ducts, including the gallbladder.
This includes
- Diagnosis and
- therapy of liver and bile duct diseases
Hepatology is a branch of gastroenterology. Gastroenterology deals with diseases of the gastrointestinal tract and the associated organs(liver, gallbladder, pancreas).
At around 1.5 kg, the liver is the largest internal organ in humans and is located in the right upper abdomen @ Henrie /AdobeStock
What diseases do hepatologists / hepatology specialists treat?
Liver disease is also called hepatopathy. A hepatologist treats diseases in which the liver or bile duct system is affected.
The following liver diseases are possible:
- Infectious liver disease: viral hepatitis or liver abscess
- Toxic liver disease: alcoholic liver disease and drug-induced liver disease
- Benign and malignant tumors: liver cancer, liver metastases or gallbladder cancer
Doctors differentiateliver cancer into hepatocellular carcinoma and cholangiocarcinoma depending on the origin of the tumor cells.
Liver metastases are metastases of a tumor that grows elsewhere in the body. Alcohol abuse and viral hepatitis can cause liver cirrhosis
Typical gallbladder and biliary tract diseases are
- Gallstones (choledocholithiasis, cholecystolithiasis)
- Inflammations such as cholecystitis(inflammation of the gallbladder) cholangitis (inflammation of the bile duct) and
- biliary outflow disorders

What diagnostic procedures do hepatology specialists use?
During the clinical examination, the liver specialist looks for complaints and symptoms.
The following are also used:
- Laboratory tests
- medical history
- Imaging procedures
The most important imaging procedure in liver diagnostics is the ultrasound examination (sonography) of the abdomen.
It can be used to
- Detect gallstones
- monitor the progression of liver cirrhosis and
provide indications of liver metastases and liver cancer
Computed tomography (CT) is a complementary examination in liver diagnostics, as it provides a precise image of the liver. It also confirms the suspicion of a tumor (liver cancer, liver metastases, gallbladder cancer). CT can also be used to detect liver bleeding and liver cirrhosis.
Magnetic resonance imaging (MRI) is also a highly sensitive examination that complements sonography in liver diagnostics.
Endoscopic retrograde cholangiopancreatography (ERCP), a variant of endoscopy, can be used for diagnostic and therapeutic interventions.
If liver disease is suspected, the liver expert takes a tissue sample from the liver and examines it under the microscope.
Tissue sample of the liver @ Volha /AdobeStock
This enables the liver expert to distinguish cancer cells from harmless cells or diagnose liver cirrhosis, for example.
As part of laboratory tests, the liver expert examines the liver values (bilirubin, AST, ALT, GLDH, GGT etc.) in the blood. If there are deviations from the normal value, this can be an initial indication of liver disease (liver cirrhosis or hepatitis).
Serology uses immune reactions to determine whether the patient has already had contact with a pathogen, such as the hepatitis virus.
What treatments/therapies are used in hepatology?
The treatments used in hepatologydepend on the type and severity of the liver disease. They also depend on the patient's state of health.
As a preventive measure, doctors recommend vaccination against hepatitis A and hepatitis B.
If the patient already has hepatitis, medication against the hepatitis viruses is used (antivirals).
As liver cancer responds poorly to cytostatics, partial removal of the liver (partial liver resection) is the treatment of choice for liver cancer.
Minimally invasive procedures are also used for inoperable liver cancer.
Examples include
- Laser-induced thermotherapy
- Radiofrequency-induced thermotherapy
- Cryotherapy
Doctors can also surgically remove liver metastases.
A portosystemic shunt is used to reduce portal vein hypertension, which occurs in the case of liver cirrhosis. This creates a connection between two vessels.
A liver transplant is the last treatment option. It is only used when the liver has been destroyed to such an extent that liver failure is imminent.
Which specialists are hepatology specialists?
A specialist in hepatology is called a hepatologist (liver specialist, liver expert). The term hepatologist is not entirely correct because there is no special training for this term in Germany.
A gastroenterologist sometimes calls himself a hepatologist because he has completed further training as a specialist in internal medicine and gastroenterology.
A hepatologist is therefore an internist who specializes in diseases of the gastrointestinal tract (in particular the liver and bile duct system).
Medical spectrum
Therapies
Diseases
- Biliary colic
- Cancer of the gallbladder
- Childhood liver disorders
- Cholangitis
- Cholestasis
- Cholesystitis
- Cirrhosis of the liver
- Disorders of the biliary tract
- Fatty liver
- Gallbladder disorders
- Gallstones
- Hepatic fibrosis
- Hepatitis
- Hepatitis B
- Hepatitis C
- Jaundice / Icterus
- Liver cancer
- Liver disorders
- Liver failure
- Liver metastases