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What is Liver Biopsy

A Liver biopsy is a procedure in which a needle is inserted into the liver to collect a sample of liver tissue.Thereafter it is analyzed by specialist pathologists to diagnose and/or stage a variety of disorders of the liver.

When is a Liver biopsy needed?

A liver biopsy is most often done in one of the following scenarios:

  • Persistently abnormal liver function tests.
  • Unexplained yellowing of the skin ie Jaundice.
  • A liver abnormality incidentally found on imaging(USG/CT/MRI)
  • Unexplained enlarged liver.
  • Determine the severity of a known liver disease ie Staging.
  • Determine how well treatment for liver disease is working
  • Monitoring after liver transplant
  • Ongoing, unexplained fevers

Diseases that may need a Liver Biopsy:

Some common liver diseases for which liver biopsy is commonly performed are:

  • Nonalcoholic fatty liver disease
  • Chronic hepatitis B or C
  • Alcoholic liver disease
  • Autoimmune hepatitis
  • Primary biliary cirrhosis
  • Primary sclerosing cholangitis
  • Wilson’s disease

Usually, there are no major complications, however, rarely, bleeding, pain or leak of bile from the liver or gallbladder may occur.

Types of Liver Biopsy :

Liver biopsy is usually done via one of the following three routes:

  • Percutaneous – This is done by inserting a thin needle through the abdomen into the liver.It is the most common type.
  • Transjugular – This is done by a vein in the neck and is done when patients have blood-clotting problems or fluid in the abdomen.
  • Laparoscopic – This is done by a small abdominal incision, usually done if samples are needed from a very specific area of the liver.

How is it a Liver Biopsy performed?

Pre-procedure Preparation

  • You should inform your doctor about any pre-existing medical conditions (heart or lung disease), pregnancy, allergies and all the medications you are on. Special precautions are taken if someone is on blood-thinning drugs like aspirin, warfarin, clopidogrel or enoxaparin etc.

Tests will be performed prior to liver biopsies like blood count, platelets, PT(INR) and USG.

During the procedure:

You will have to lie on your back, with r right elbow out to the side and your right hand under your head and be as still as possible during the procedure.

  • The doctor will clean and numb an area on your upper abdomen with a local anaesthetic and then make a small incision over the abdomen and insert a needle into the liver to take a small sample of tissue for analysis.

After the procedure:

  • You will be kept in observation for up to 6 hours.
  • You may feel some minor discomfort or pain and if needed, pain medications will be given to you.
  • You should not perform any strenuous physical activity for at least 24 hours post-biopsy.
  • The biopsy report usually will arrive after a couple of days and the doctor will discuss the same with you.