This procedure is used to take a tissue of the liver in order to diagnose and evaluate symptoms which may be caused by abnormal liver function. Before you arrive at the hospital for the biopsy, there are a few preparations: blood samples will be taken in order to determine blood clotting capabilities and make sure to mention any medications you are taking to your physician prior to the procedure. A chest x-ray may be taken. You should not ingest aspirin, ibuprofen or any anticoagulants one week prior to your biopsy as this will affect the healing process. Do not eat or drink anything 8 hours before the procedure. Speak with your physician about any other special instructions, including if and when to take regular medications.
When you arrive at the hospital, the nurse will begin an intravenous line in order to administer medication. There are a few types of biopsy methods that can be used: percutaneous liver biopsy is the most common. This type of biopsy is done through the skin. First, the area of the body through which the biopsy needle will pass is anesthetized using either Novocain or Lidocaine. The biopsy needle is then inserted into this area. While the patient is holding his/her breath, the biopsy needle is quickly inserted and retracted from the liver--this only takes a second or two. This action removes a small piece of tissue from the liver which can be analyzed in the lab to diagnose abnormalities. The physician may use an ultrasound in order to determine specific areas of the liver for biopsy. There is minimal pain after this pressure at the insertion point of the biopsy needle. In some cases, pain medication may be given for a few hours.
Another type of liver biopsy is laparoscopic-assisted. In this type of procedure, the physician uses a laparoscope, a think viewing tube, which will reflect images of the liver onto a TV monitor while the biopsy is being performed. This type of procedure is used when the physician would like to take samples from specific areas of the liver.
Your physician may also choose to do a transvenous liver biopsy. In this type of procedure, a tube called a catheter is inserted into the neck and down to the liver. The biopsy needle is inserted through the catheter. This type of biopsy is usually performed for patients that have blood clotting problems or have fluid in the abdomen.
After the surgery, you may be kept in the hospital for up to 24 hours for observation, just to make sure there are no complications. Usually, you may go home with a driver after the sedatives have worn off. You should not exert yourself for at least a week while healing from the biopsy. You may experience some pain at the insertion point of the needle or in your right shoulder. This is normal and the pain will disappear either in a few hours or a few days. Your physician may recommend Tylenol for pain, but you should not take aspirin or ibuprofen, as these types of medication will interfere with blood clotting, which is essential for the healing process.
Complications resulting from liver biopsy are rare. However, they do exist. 1 out of 100 patients will experience bleeding at the site of the biopsy. These cases rarely require transfusions. 1 out 1000 patients will require surgery to repair this type of complication. Other complications include: puncture of the lungs, puncture of the gallbladder, infection and pain.
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