A liver biopsy is a procedure to remove a small piece of liver tissue, so it can be examined under a microscope for signs of damage or disease. Your doctor may recommend a liver biopsy if blood tests or imaging techniques suggest you might have a liver problem. A liver biopsy also is used to determine the severity of liver disease. This information helps guide treatment decisions.
The most common type of liver biopsy is called percutaneous liver biopsy. It involves inserting a thin needle through your abdomen into the liver and removing a small piece of tissue. Two other types of liver biopsy — one using a vein in the neck (transjugular) and the other using a small abdominal incision (laparoscopic) — also remove liver tissue with a needle.
Why it's done
A liver biopsy may be done to:
Usually your doctor performs a liver biopsy only after you've had blood tests to check your liver function and imaging tests, such as ultrasound. Ultrasound uses sound waves to create images of your internal organs and tissues.
Your doctor may recommend a liver biopsy if you have:
A liver biopsy also is commonly performed to help diagnose and stage certain liver diseases, including:
A liver biopsy is a safe procedure when performed by an experienced doctor. Possible risks include:
In a transjugular procedure, a thin tube (catheter) is inserted through a large vein in your neck and passed down into the vein that runs through your liver. If you have a transjugular liver biopsy, other infrequent risks include:
The majority of complications happen within two hours of a liver biopsy, and almost all occur within 24 hours. Two to 3 percent of people having a liver biopsy need to be hospitalized because of a complication. The chance of death from a liver biopsy is about 1 in 10,000 and usually results from severe bleeding.
How you prepare
Before your liver biopsy, you'll meet with your doctor to talk about what to expect during the biopsy. This is a good time to ask questions about the procedure and make sure you understand the risks and benefits.
Your doctor or nurse will let you know if you need to temporarily avoid any of your other medications.
Care after the biopsy
What you can expect
Percutaneous liver biopsy, the most common type, isn't an option for some people. Your doctor may use a different form of liver biopsy if you:
If you aren't a candidate for percutaneous liver biopsy, you may have a transjugular liver biopsy, also called transvenous liver biopsy. Laparoscopic liver biopsy isn't used often, but may be recommended if you have cancer, an infection, a mass in your abdomen or ongoing abdominal pain. Laparoscopic biopsy allows your doctor to obtain tissue samples from a larger or more targeted area.
Before the procedure
Just before your biopsy you will:
During the procedure
The steps involved in liver biopsy vary according to the type:
After the procedure
Someone else should drive you home. Most people get back to their usual activities within a day or two after a liver biopsy. Avoid lifting more than 10 to 15 pounds for at least 24 hours. Your liver tissue goes to a laboratory to be examined by a doctor who specializes in diagnosing disease (pathologist). The pathologist will look for signs of disease and damage to the liver.
Call your doctor if you experience:
Your biopsy report should come back from the pathology lab within a few days to a week. At a follow-up visit, your doctor will explain the results. You may be diagnosed with a liver disease, or your liver disease may be given a stage or grade number based on how severe it is — mild, moderate or severe. Your doctor will discuss what treatment, if any, you need.
Last Updated: 2009-10-23
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