What is a liver biopsy?

A liver biopsy is a diagnostic procedure used to diagnose and/or stage (determine the severity of) a variety of liver diseases, such as nonalcoholic fatty or alcoholic liver diseases, chronic hepatitis B or C, autoimmune hepatitis, primary biliary cirrhosis, hemochromatosis or Wilson’s disease.

During a liver biopsy, a small needle is inserted into the liver to collect a liver tissue sample.

Who is a candidate for a liver biopsy

Your Mercy Health doctor will perform a liver biopsy to determine the cause of symptoms such as:

  • Abnormal liver enzymes on liver blood tests
  • Jaundice (unexplained yellowing of the skin)
  • Enlarged liver with unknown cause
  • Persistent, unexplained fevers

Your doctor may also order a liver biopsy if you:

  • Have a liver abnormality that is found on an ultrasound, CT scan or nuclear scan
  • Have been diagnosed with liver disease and your doctor would like to determine what stage you are in

Risks of a liver biopsy

Although a liver biopsy is generally a safe procedure, complications may include:

  • Pain at the biopsy site – typically the pain is mild, but if it becomes severe, you may need pain medication
  • Bleeding – if severe, you may need a blood transfusion to stop the bleeding
  • Infection – in some cases bacteria may enter the abdominal cavity or enter the bloodstream
  • Injury to an internal organ – in rare cases, the biopsy needle may hit the gallbladder or lung during the procedure

If you are having a transjugular procedure, complications can include:

  • Hematoma in the neck – blood can pool at the catheter insertion site
  • Nerve damage to the facial nerves – can cause problems such as drooping eyelids
  • Voice problems – temporary loss of voice
  • Lung puncture if needle mistakenly hits the lung

What to expect during a liver biopsy

A liver biopsy is usually performed as an outpatient procedure in a clinic office or during surgery to remove part of the liver. What you can expect will depend on the type of liver biopsy you are having. There are three types of liver biopsies:

Percutaneous biopsy

A percutaneous biopsy is typically performed using ultrasound guidance to locate the liver and guide the biopsy needle into the liver. The procedure only takes approximately one minute as the needle passes into and out of the liver. You will need to hold your breath as the needle is inserted and removed.

Transjugular biopsy

A transjugular biopsy is performed via an incision in the jugular vein. A tube is inserted into the vein and threaded into a large vein in the liver. When in position, contrast dye is injected in the tube so your doctor can see the large vein in the liver through X-ray images. The biopsy needle will then be inserted into the tube and into the liver so that liver tissue samples can be collected. Once the samples have been obtained, the tube is removed, and incision site is closed.

Laparoscopic biopsy

A laparoscopic biopsy is performed under general anesthesia. Your doctor will make incisions in the abdomen and insert surgical instruments and a video camera into the cavity to visualize the liver. Your doctor will use the images to remove liver tissue samples. Once the samples have been obtained, the incisions are closed.

After any biopsy, the liver tissue will be sent to a laboratory to be analyzed by a pathologist to help doctors diagnose liver disease.

Recovery from a liver biopsy

Most patients go home the day of a liver biopsy. If you were given general anesthesia, you will need to coordinate a ride home from the hospital. Before leaving the clinic, your doctor will give you detailed instructions including:

  • How to care for incision sites
  • Pain management options
  • Activity level – gradually return to your activity level over a week and do not lift anything heavy for a week or so
  • Follow-up appointment schedule for results

If you experience any of the following symptoms after surgery, please call your doctor or 911 immediately:

  • Fever or chills
  • Difficulty breathing
  • Dizziness
  • Severe pain

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