Liver Biopsy
A liver biopsy is a valuable procedure used to diagnose and stage liver disease. With this procedure, a small piece of liver tissue -- about one inch to an inch and a half long and wide enough to fit into a needle -- is obtained and examined.
The biopsy can help establish a diagnosis, and therefore direct treatment if the cause of liver disease is uncertain. In other cases -- such as heaptitis C or nonalcoholic fatty liver disease -- the cause of disease may be obvious. Since the biopsy is used to help stage the disease it is therefore valuable in directing subsequent treatment. The quantity of iron found in the liver during the biopsy is also valuable in staging and directing therapy and follow-up for other diseases, such as hemochromatosis.
There are several precautions you must take into consideration before your biopsy. You generally are asked to fast the night prior to the biopsy. Also, it is important for you to undergo clotting studies before the biopsy to ensure that your blood clots properly and that the procedure is safe to perform. If you take a blood thinner such as Coumadin, Plavix, Ticlid, Persantine, Aggrenox, asprin, or non-steroidal anti-inflammatory drugs it is important that you stop taking them before the biopsy is performed.
When you arrive to the hospital, you will receive an IV in the outpatient procedure area. An ultrasound then will be used to identify the position of the liver and to identify the safest location within the liver to perform the biopsy. A sedative is usually given, although it is important that you be conscious enough to follow simple commands.
The biopsy site is generally along the right chest wall in between the ribs. The site is carefully cleaned and then a local anesthetic is administered with a small needle. The remainder of the procedure is generally painless. You will be asked to breathe a certain way. The biopsy needle then will be quickly inserted and tissue will be extracted in a fraction of a second. This tissue will then be placed in a fixative and sent to the laboratory for staining and examination using a microscope.
You will then be asked to lie on your right side for two hours, with your pulse and blood pressure monitored periodically for two to four hours. If pain occurs at the site of your biopsy or in the right shoulder, a medication will be given to relieve the pain. Generally any pain occurs within the first hour or two following the biopsy. When you go home, there is only some mild soreness at the biopsy site. Detailed instructions will be given in terms of resuming activity and an appointment will be made to discuss biopsy findings and treatment recommendations.
While liver biopsy it is often met with considerably anxiety, it is a procedure with a low risk and a low incidence of inconvenience. Patients are generally relieved and surprised at how easy and quick the procedure is.Liver biopsy is generally a very safe procedure, however complications can occur as is with any medical procedure. These include internal bleeding, perforation of the gallbladder or lung, introduction of infection, and prolonged pain. While all of these problems are rare, they may require readmission to the hospital or an overnight stay in the hospital.
