It will be guided using an imaging test such as: Ultrasound. Uses high-frequency sound waves to make images. MRI magnetic resonance imaging. Uses a combination of large magnets, radio frequencies, and a computer to make images.
CT scan computed tomography scan. Uses both X-rays and computer technology to make horizontal or cross-sectional images. Why might I need a liver biopsy? A biopsy may be done if you have: An enlarged liver Yellowing of the skin and eyes jaundice Abnormal lab tests that suggest liver disease A liver biopsy may be used to see if you have a condition such as: Hepatitis.
This is a redness and swelling inflammation of the liver that sometimes causes long-lasting damage. It is caused by viruses, illegal drugs, alcohol, parasites, or other conditions. Alcoholic liver disease. Liver damage caused by alcohol abuse. Liver tumor. An abnormal lump or mass of tissue.
Tumors can be noncancerous benign or cancerous malignant. Fatty liver. A buildup of fat in the liver cells. Metabolic or autoimmune disease. Fibrosis of the liver. The growth of scar tissue due to infection, inflammation, injury, or even healing. Your provider may have other reasons to recommend a liver biopsy. What are the risks of a liver biopsy? Some possible complications may include: Pain and bruising at the biopsy site Bleeding for a long time from the biopsy site, either inside or outside the body Infection near the biopsy site Accidental injury to another organ If your liver biopsy is done using X-rays, the amount of radiation used is small.
In some cases a liver biopsy may not be advised. This includes cases where you have: A condition that affects the blood's ability to clot A lot of fluid collecting in your belly or abdomen severe ascites An infection of your biliary tract or the part of your belly around your liver You may have other risks that are unique to you. How do I get ready for a liver biopsy? Your healthcare provider will explain the procedure to you. Ask him or her any questions you have about the procedure.
You may be asked to sign a consent form that gives permission to do the procedure. Read the form carefully and ask questions if anything is not clear. Your provider will ask questions about your past health.
He or she may give you a physical exam. This is to make sure you are in good health before you have surgery. You may also need blood tests and other diagnostic tests. Tell your provider if you are sensitive to or allergic to any medicines, latex, tape, and anesthesia medicines local and general. Tell your provider about all the medicines you take. This includes both over-the-counter and prescription medicines.
It also includes vitamins, herbs, and other supplements. Tell your provider if you have a history of bleeding disorders or if you are taking any blood-thinning anticoagulant medicines, aspirin, ibuprofen, or other medicines that affect blood clotting.
You may need to stop taking these medicines before the biopsy. Tell your provider if you are pregnant or think you may be pregnant. You may be asked to not eat or drink anything before the biopsy. Before your biopsy, you'll have a blood test to check your blood's ability to clot. If you have blood-clotting problems, you may be given a medication before your biopsy to reduce the risk of bleeding.
You may receive a sedative before your liver biopsy. If this is the case, arrange for someone to drive you home after the procedure. Have someone stay with you or check on you during the first night.
Many doctors recommend that people spend the first evening within an hour's driving distance of the hospital where the biopsy is done, in case a complication develops. What you can expect during your liver biopsy will depend on the type of procedure you'll undergo. A percutaneous liver biopsy is the most common type of liver biopsy, but it isn't an option for everyone.
Your doctor may recommend a different form of liver biopsy if you:. A liver biopsy is done at a hospital or outpatient center. You'll likely arrive early in the morning. Percutaneous biopsy. To begin your procedure, your doctor will locate your liver by tapping on your abdomen or using ultrasound images. In certain situations, ultrasound might be used during the biopsy to guide the needle into your liver. You'll lie on your back and position your right hand above your head on the table.
Your doctor will apply a numbing medication to the area where the needle will be inserted. The doctor then makes a small incision near the bottom of your rib cage on your right side and inserts the biopsy needle.
The biopsy itself takes just a few seconds. As the needle passes quickly in and out of your liver, you'll be asked to hold your breath.
Transjugular biopsy. You'll lie on your back on an X-ray table. Your doctor applies a numbing medication to one side of your neck, makes a small incision and inserts a flexible plastic tube into your jugular vein. The tube is threaded down the jugular vein and into the large vein in your liver hepatic vein.
Your doctor then injects a contrast dye into the tube and makes a series of X-ray images. The dye shows up on the images, allowing the doctor to see the hepatic vein. A biopsy needle is then threaded through the tube, and one or more liver samples are removed. Usually this involves inserting a very thin, hollow tube a catheter into a vein in your neck or groin. The skin will be made numb by a local anaesthetic before the procedure.
The catheter is then gently guided to the veins inside your liver. A small needle on the tip of the catheter makes a tiny hole in the wall of the vein. The needle collects a sample of liver tissue which is then retained in the catheter as it is taken out of your body.
This second procedure has less chance of causing bleeding if you have problems with blood clotting. In people with no clotting problems, the first method is normally used. Your hospital will advise you which method will be used to take the biopsy. Another type of liver biopsy is a laparoscopic liver biopsy which is undertaken at the time of surgery for another indication - eg, gallbladder removal.
There is no special preparation for this procedure apart from what you should do for the surgery itself. Another method for performing a liver biopsy is via a camera endoscopy. An endoscopic ultrasound scan uses an endoscope with an ultrasound probe attached to create detailed pictures of internal organs and structures.
This is a new technique which is not available in all hospitals. Because of the local anaesthetic, you should not feel any pain. However, you may feel some mild discomfort or pressure as the doctor pushes on the needle. Any pain or discomfort you experience is usually eased with painkillers. You will usually have a blood test done shortly before the biopsy, to check how well your blood will clot.
This is to make sure that you are not likely to bleed following the biopsy. You may be advised not to take any medicines that affect blood clotting, such as aspirin and warfarin, for one week before the biopsy. You will usually be advised to take your other medication as normal before the biopsy. However, you may need to discuss this with your doctor.
You will need to sign a consent form at some point before the procedure to say that you understand what it involves, and the small risk involved. Complications are very uncommon. The most common complication is some mild pain or discomfort in the area where the liver biopsy was taken. In a small number of cases there is some bleeding from the biopsy site.
This is usually minor, and soon stops. The main reason you are monitored for several hours after the biopsy is to check for bleeding. A rare complication is for bile to leak from the liver internally.
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