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Liver Biopsy by Daus Mahnke, MD

En Español (Spanish Version)

Definition | Reasons for Procedure | Possible Complications | What to Expect | Call Your Doctor

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

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 DynaMed's Systematic Literature Surveillance : 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.

Last reviewed May 2013 by Marcin Chwistek, MD; Michael Woods, MD

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