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Liver Biopsy

(Biopsy of Liver)
  • Definition

    This is a procedure to obtain a sample of your liver tissue.
  • Reasons for Procedure

    Biopsies of the liver are usually done to evaluate:
    • Abnormal blood tests such as elevated liver enzymes, bilirubin, copper, or iron in the blood
    • An enlarged liver
    • The severity of liver diseases
    • The progress of therapy for liver diseases
    • A liver mass
    • The liver after a liver transplant
  • Possible Complications

    If you are planning to have a liver biopsy, your doctor will review a list of possible complications, which may include:
    • Pain
    • Bleeding
    • Infection
    • Perforation of the gallbladder or intestines
    • Puncture of the lung
    Factors that may increase the risk of complications include:
    • Smoking
    • Chronic disease
    • Alcoholism
    • Malnutrition
  • What to Expect

    Prior to Procedure
    Your doctor may do the following:
    • Physical exam
    • Blood tests
    • Ultrasound
    Before your biopsy:
    • Avoid eating or drinking for 8-12 hours.
    • Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure, like:
      • Anti-inflammatory drugs such as ibuprofen
      • Blood thinners
      • Anti-platelet medications
    • Arrange for someone to drive you home after the biopsy.
    Anesthesia
    If local anesthesia is used, then only the area that is being operated on is numbed. It is given as an injection and may also be given with a sedative
    Description of the Procedure
    There are different techniques used to do a liver biopsy, including:
    • Conventional liver biopsy
    • Laparoscopic liver biopsy—done when the biopsy needs to be taken from a specific area of the liver
    • Transvenous liver biopsy—done if your blood clots poorly or you have a lot of fluid in your abdomen
    Conventional Liver Biopsy
    You will lie on your back with your right hand behind your head. An ultrasound or CT scan may be used to help guide the placement of the needle. The skin will be cleaned. Next, medication will be injected to numb the area. A small incision will be made. You will need to exhale and hold your breath while the needle is inserted. Sometimes, the needle will need to be inserted several times. After the procedure, the area will be bandaged.
    Placement of Liver Biopsy Needle
    Placement of Liver Biopsy Needle
    Copyright © Nucleus Medical Media, Inc.
    Placement of Liver Biopsy Needle
    Placement of Liver Biopsy Needle
    Copyright © Nucleus Medical Media, Inc.
    Laparoscopic Liver Biopsy
    Your doctor will make a tiny incision. A long tool with a camera on the end will be passed into your abdomen in the area of the liver. It will send images of the liver to a TV screen. Additional incisions will be made to pass other tools. These tools will be used to remove samples of the liver.
    Transvenous Liver Biopsy
    A tiny flexible tube will be threaded into a vein in your neck or groin. This tube will be threaded all the way into the veins in your liver. A biopsy needle will be passed through the tube to get a biopsy sample.
    Immediately After Procedure
    You will lie on your right side for at least two hours.
    How Long Will It Take?
    About 15-20 minutes
    Will It Hurt?
    You will have mild pain or cramping at the biopsy site. You may also have pain in the right shoulder. The pain should last for less than 30 minutes.
    Postoperative Care
    When you return home after the procedure, do the following to help ensure a smooth recovery:
    • If a sedative was given, do not drive for at least 24 hours.
    • Rest the remainder of the day.
    • Do not exercise or lift heavy objects for at least a week. Ask your doctor when you can resume normal activities.
    • Eat your normal diet.
    • Ask your doctor when you can resume taking your medications.
    • Ask your doctor about when it is safe to shower, bathe, or soak in water.
    • Be sure to follow your doctor's instructions.
    The biopsy results will take 1-4 weeks. You and your doctor will discuss the results.
  • Call Your Doctor

    After arriving home, contact your doctor if any of the following occurs:
    • Signs of infection, including fever and chills
    • Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
    • Severe abdominal pain, nausea, or vomiting
    • Lightheadedness
    • Severe shoulder pain
    • Trouble breathing, cough, or chest pain
    In case of an emergency, call for medical help right away.
  • RESOURCES

    American Liver Foundation http://www.liverfoundation.org

    National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov

    CANADIAN RESOURCES

    Canadian Liver Foundation http://www.liver.ca

    Health Canada http://www.hc-sc.gc.ca

    References

    Liver biopsy. American Liver Foundation website. Available at: http://www.liverfoundation.org/abouttheliver/info/liverbiopsy. Updated October 4, 2011. Accessed May 29, 2013.

    Liver biopsy. National Digestive Diseases Information Clearinghouse website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/liverbiopsy. Updated April 23, 2012. Accessed May 29, 2013.

    6/3/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.

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