What is Liver Biopsy

Liver biopsy is a procedure in which a tissue sample is taken from the liver and examined under a microscope. The liver is a large organ in the upper right side of the abdomen.

There are three types of liver biopsies:

• Percutaneous. A needle is used to remove a sample through an incision in your abdomen.
• Laparoscopic. Several incisions are made in the abdomen. A sample is removed with the help of a tiny camera.
• Transjugular. An incision is made in your neck in the area of the jugular vein. A sample is removed through a small flexible tube that is passed down the blood vessel and into your liver.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems can occur and include:

• Bleeding.
• Infection.
• Bruising.
• Pain.
• Injury to nearby organs or tissues, such as nerves, gallbladder, liver, or lungs.

What happens before the procedure?

Eating and drinking restrictions

• You may be asked not to drink or eat for 6–8 hours before the liver biopsy. You may be allowed to eat a light breakfast. Talk to your health care provider about when you should stop eating and drinking.

Medicines

Ask your health care provider about:

• Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
• Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
• Taking over-the-counter medicines, vitamins, herbs, and supplements.

General instructions

• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
• Plan to have someone take you home from the hospital or clinic.
• Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital or clinic. This is important.
• You may have blood or urine tests.
• Ask your health care provider what steps will be taken to prevent infection. These may include:
  • Removing hair at the surgery site.
  • Washing skin with a germ-killing soap.
  • Taking antibiotic medicine.

What happens during the procedure?

• An IV will be inserted into one of your veins.
  • You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to numb the area (local anesthetic).
  • A medicine to make you fall asleep (general anesthetic).
• Your health care provider will use one of the following procedures to remove samples from your liver. These procedures may vary among health care providers and hospitals.

Percutaneous liver biopsy

• You will lie on your back, with your right hand over your head.
• A health care provider will locate your liver by tapping and pressing on the right side of your abdomen, or by using an ultrasound or CT scan.
• A local anesthetic will be used to numb an area at the bottom of your last right rib.
• A small incision will be made in the numbed area.
• A biopsy needle will be inserted into the incision.
• Several samples of liver tissue will be taken. You will be asked to hold your breath as each sample is taken.
• The incision will be closed with stitches (sutures).
• A bandage (dressing) may be placed over the incision.

Laparoscopic liver biopsy

• You will lie on your back.
• Several small incisions will be made in your abdomen.
• Your health care provider will pass a tiny camera through one incision. The camera will allow the liver to be viewed on a TV monitor in the operating room.
• Tools will be passed through the other incision or incisions.
• Samples of the liver will be removed using the tools.
• The incisions will be closed with stitches (sutures).
• A bandage (dressing) may be placed over the incisions.

Transjugular liver biopsy

• You will lie on your back on an X-ray table, with your head turned to your left.
• An area on your neck, just over your jugular vein, will be numbed.
• An incision will be made in the numbed area.
• A tiny tube will be inserted through the incision. The tube will be passed into the jugular vein to a blood vessel in the liver called the hepatic vein.
• A dye will be injected through the tube.
• X-rays will be taken. The dye will make the blood vessels in the liver light up on the X-rays.
• The biopsy needle will be placed through the tube until it reaches the liver.
• Samples of liver tissue will be taken with the biopsy needle.
• The needle and the tube will be removed.
• The incision will be closed with stitches (sutures).
• A bandage (dressing) may be placed over the incision.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until you leave the hospital or clinic.
• You will be asked to rest quietly for 2–4 hours or longer.
• You will be closely monitored for bleeding from the biopsy site.
• You may be allowed to go home when the medicines have worn off and you can walk, drink, eat, and use the bathroom.

Summary

• A liver biopsy is a procedure in which a tissue sample is taken from the liver and examined under a microscope.
• This is a safe procedure, but problems can occur, including bleeding, infection, pain, or injury to nearby organs or tissues.
• Ask your health care provider about changing or stopping your regular medicines.
• Plan to have someone take you home from the hospital or clinic and to be with you for 24 hours after the procedure.