A liver biopsy is a procedure that involves obtaining a small piece of liver tissue, for analysis in the laboratory. Liver biopsy is done either to diagnose the cause of liver disease or determine the severity of liver disease. Patients with one of the following conditions may need a liver biopsy.
- Fatty liver disease
- Chronic hepatitis B or C
- Autoimmune liver disease
- Alcoholic liver disease
- Individuals with unexplained abnormality of liver function tests
- Liver mass or suspected liver cancer
- Post liver transplant: A biopsy is done to assess the condition of the transplanted liver, diagnose rejection and disease recurrence.
Testing before liver biopsy
You will undergo an ultrasound scan of the liver prior to a biopsy. You will also have blood tests to determine that your blood clotting functions are normal. Normal blood clotting is important to prevent bleeding after the biopsy. You will be asked to come fasting in the morning for the procedure. The biopsy procedure is usually done as a daycare procedure and you will be able to go home by the evening. Some patients (especially small children) need admission for one day for the biopsy. Patients should stop any medicine that can increase the risk of bleeding atleast one week prior to the procedure. These include the following:
- Aspirin or aspirin-containing medicines.
- Non-steroidal anti-inflammatory drugs (NSAIDS) or pain medications such as ibuprofen, diclofenac, or naproxen.
- Medicines used to prevent blood clots, such as warfarin, acitrom and heparin.
- Certain medicines for heart conditions such as clopidogrel, dipyridamole, and ticlopidine.
Liver Biopsy procedure
- Percutaneous Liver Biopsy : This is the most common technique of performing a liver biopsy. A special needle in passed into your liver through the lower part of the chest wall on the right side of the body. It takes only a few seconds to take a small sample. The procedure may be done under guidance of ultrasound to localize the area from where biopsy is required. A small bandage is applied to the biopsy site; stitches are not needed.
- Transjugular Liver Biopsy : In this technique, the biopsy is done by passed a special catheter through the blood vessels in the neck. This catheter is guided into the blood vessels of the liver and a sample of the liver is taken. This procedure is required for patients in whom blood is not clotting well and in those who have fluid in the abdomen that makes a regular percutaneous biopsy risky. During this procedure, pressures in the veins of the liver can also be measured that gives additional information about the severity of liver disease.
Liver Biopsy Complications
A liver biopsy is a very safe procedure when performed by an experienced doctor. The most common problems include mild pain and a minor decrease in blood pressure. More serious complications, such as bleeding, infection, and injury to nearby organs, are very rare. The risk of a serious complication is about 1-2 percent.