A liver biopsy is a procedure to remove a small piece of liver tissue so it can be examined under a microscope for signs of damage or disease. It may also be done to determine the severity of disease, which helps your doctor plan your treatment, as well as determine the effectiveness or success of treatment. Your doctor may recommend a biopsy if your liver has an abnormality of unknown cause or if a liver mass was detected on imaging tests. It is also commonly used to diagnose and stage nonalcoholic fatty liver disease, chronic hepatitis, alcoholic liver disease, primary biliary cirrhosis, primary sclerosing cholangitis, hemochromatosis, and Wilson’s disease.
A liver biopsy may be done to:
-Diagnose a liver problem that can't be otherwise identified
-Obtain a sample of tissue from an abnormality found by an imaging study
-Determine the severity of liver disease — a process called staging
-Help develop treatment plans based on the liver's condition -Determine how well treatment for liver disease is working
-Monitor the liver after a liver transplant
-Your doctor may recommend a liver biopsy if you have:
-Abnormal liver test results that can't be explained such as; a mass (tumor) or other abnormalities on your liver as seen on imaging tests and ongoing, unexplained fevers A liver biopsy also is commonly performed to help diagnose and stage certain liver diseases, including:
-Nonalcoholic fatty liver disease
-Chronic hepatitis B or C
-Alcoholic liver disease
-Primary biliary cirrhosis
-Primary sclerosing cholangitis
-A liver biopsy is the golden standard for diagnosing problems with the liver. Once a diagnosis is correctly made, physicians can begin appropriate treatment.
-A liver biopsy is also performed in order to determine whether or not liver disease is stable or has progressed over a period of time. The results of liver biopsy may bring the patient comfort of their status of the disease, even if the biopsy shows that the individual's disease has progressed.
-It is considered an invasive procedure
The most common typeof liver biopsy performed is known as a percutaneous liver biopsy. Before the procedure, you will be asked to change into a hospital gown. You will be instructed tol lie on your back, with your right elbow out to the side and your right hand under your head. It is important that you remain as still as possible during the procedure. An ultrasound may be used to mark the location of your liver. You may receive a small dose of a sedative just prior to the procedure along with the administration of a local anesthetic to numb an area on your upper abdomen. The doctor will then make a small incision on your upper abdomen and insert a needle into this incision to take a small sample of liver tissue for analysis.The whole procedure is very quick and takes takes about 5 minutes
After the procedure, you will be moved to a recovery room for up to 4 hours for observation. You might experience minor pain or soreness at the biopsy site and discomfort or a dull pain in your shoulders or back. If necessary, a pain medication will be prescribed for you. Be sure to: -Avoid taking aspirin, products containing aspirin, or anti-inflammatory drugs (such as ibuprofen, Advil, Naprosyn, Indocin, or Motrin) for one week after the procedure. You may take acetaminophen (Tylenol) if needed. -Not perform vigorous physical activity or heavy lifting for at least 24 hours and up to 1 week after the biopsy. Your doctor will discuss the biopsy results with you several days after the procedure.
After the biopsy, you can expect to taken to a recovery room, where a nurse will monitor your blood pressure, pulse and breathing. You will be asked to rest quietly for two to four hours, or longer if you had a transjugular procedure. Some pain and soreness can occur where the needle was inserted, which may last as long as a week Have someone drive you home, since you won't be able to drive until the sedative wears off Avoid lifting more than 10 to 15 pounds for one week Be able to get back to your usual activities gradually over a period of a week
Pain at the biopsy site is a common complication after liver biopsy. You may experience tightness in your abdomen or pain that radiates to your right shoulder. These are usually mildly uncomfortable. You can take painkiller medication to manage this pain, if needed. Infection, which can be treated effectively with antibiotics. Excessive bleeding that requires transfusion and accidental injury to a nearby organ, such as the gallbladder or a lung, occur in less than 1 out of 1,000 patients. More serious complications that can result in death occur in less than 1 out of 10,000 patients. Uncommon complications that may occur after a liver biopsy include: -infection, which may lead to sepsis NIH external link -a collapsed lung, called a pneumothorax NIH external link -a buildup of blood in the space between the lung and the chest wall, called a hemothorax -injury to other organs
What happens once I am discharged from the hospital and can return home?
Your liver tissue will be sent the laboratory to be examined by a doctor who specializes in diagnosing disease (pathologist). The pathologist will look for signs of disease and damage to the liver. Your biopsy report should come back from the pathology lab within a few days to a week. At a follow-up visit, your doctor will explain the results. You may be diagnosed with a liver disease, or your liver disease may be given a stage or grade number based on the severity — mild, moderate or severe. Your doctor will discuss what treatment, if any, you will need
What are the different types of liver biopsies are that can be performed?
There are 3 types of liver biopsies: Percutaneous liver biopsy. The most common method. You are given a local anesthetic. A small needle is put into your liver to take a sample. Laparoscopic liver biopsy. You are given a general anesthetic. A thin lighted tube (laparoscope) is put into your skin through a tiny cut or incision. The tube has a tiny video camera attached. Your provider can see the inside of your belly on a computer screen. A needle is put through another tube to remove the sample. Transvenous liver biopsy. This method may be used if you have blood-clotting problems or fluid in your belly. You are given a local anesthetic. An incision is made into a vein in your neck. A hollow tube is put through the vein down to your liver. A contrast dye is put into the tube and X-rays are made. The dye lets the vein show up more clearly on the X-rays. A needle goes through the tube to your liver. Tissue samples are removed through the tube.