Liver Biopsy

A liver biopsy is a procedure to obtain a sample of liver tissue so it can be examined with a microscope for signs of damage or disease. A liver biopsy is performed when a liver problem is difficult to diagnose with blood tests or imaging techniques, such as ultrasound, CT scan or MRI. Typically, a liver biopsy is performed to confirm a diagnosis or to estimate the degree of liver damage - a process called staging. Diagnosis and staging can be very important to guide treatment of cirrhosis of the liver, liver cancer, and other conditions.

What to Expect

Knowing what to expect can help take the stress out of any procedure. Here's what you can expect during a liver biopsy procedure.

The most commonly used technique for collecting a liver sample is percutaneous liver biopsy. For this method, a hollow needle is inserted through the abdomen into the liver to remove a small piece of tissue. Imaging techniques, such as ultrasound or CT may be used to help guide the needle into the liver.

During the procedure, patients lie on their back on a table with their right hand resting above their head. A local anesthetic is applied to the area where the biopsy needle will be inserted. If needed, an IV tube is used to give sedatives and pain medication.

The doctor makes a small incision in the abdomen, either toward the bottom of the rib cage or just below it, and inserts the biopsy needle. Patients will be asked to exhale and hold their breath while the needle is inserted and a liver sample is quickly withdrawn. Several samples may be collected, requiring multiple needle insertions.

After the biopsy, patients must remain at rest for several hours to reduce the risk of bleeding. Patients are then monitored after the biopsy before being sent home. Alternative methods of liver biopsy, such as transvenous liver biopsy and laparoscopic liver biopsy, may be used depending on a patient's specific needs. Your physician will determine the appropriate method based on your specific health history and condition.

How to Prepare

Preparation for a liver biopsy may vary, depending on whether or not you will be sedated. You may be asked to obtain laboratory tests prior to the biopsy and to temporarily stop taking medications that affect blood clotting or interact with sedatives, which are sometimes given during a liver biopsy. You should inform your doctor of any medicines you are taking, including over-the-counter medications.

Patients who will be sedated should not eat or drink for 8 hours before the liver biopsy and should arrange a ride home, as driving is prohibited for 12 hours after the procedure. Mild sedation is sometimes used during liver biopsy to help patients stay relaxed. Unlike general anesthesia where patients are unconscious, patients can communicate while sedated but then often have no memory of the procedure. Sedatives are often given through an intravenous (IV) tube placed in a vein.