In a liver biopsy, a doctor uses a long needle to remove very small pieces of the liver. The liver tissue is then sent to a laboratory for testing.
What happens during a liver biopsy?
Since some patients with liver damage have problems with blood clotting, doctors usually do blood tests to check clotting before the procedure. Patients on medications to prevent blood clots (like coumadin) may have to adjust their medicines before the biopsy.
A liver biopsy is typically an outpatient procedure, meaning a patient goes to a clinic or hospital for a few hours, rather than overnight. Sometimes doctors give patients a sedative to help them relax during the procedure, but it is not usually necessary. The patient is asked to lie still on the back or left side while the doctor locates the liver and determines where to do the biopsy. Some doctors use an ultrasound to help them find the best spot. The small area where the needle will be inserted is cleaned and a local anesthetic (a substance that makes the area numb) is injected. The doctor then inserts a thin long needle (designed to obtain small samples from the liver) through the skin. The doctor then asks the patient to hold his/her breath and the biopsy needle is inserted and removed from the liver. It takes only a few seconds. The needle, with the piece of liver, is sent to the laboratory for examination.
Most patients have little or no pain, just a sense of pressure when the needle is inserted. A few patients report some pain that goes away when the needle is removed. Occasionally, patients report a lingering discomfort. After the biopsy, patients rest at the doctor’s office for a couple of hours (patients with blood clotting problems maybe asked to stay for several hours). The staff checks the pulse and blood pressure and make sure that there is no bleeding. There is no long recovery period, though patients should limit physical activity for a few days.
What about complications?
Liver biopsies are quick and usually no problems result. However, it is an invasive procedure and complications can occur. Complications are rare, but if they do occur, they may include infection, internal bleeding, nicking other organs with the needle, and leaking of bile from the liver or gallbladder. These complications can usually be handled quickly and successfully.
When are results available?
Examination of the liver tissue in the laboratory takes a few days. The lab will send a report to your doctor. The doctor will review the results and call or schedule an appointment to discuss the results.
How frequently are biopsies done?
Most people only need one biopsy. If a patient and doctor want to monitor the health of the liver, including liver transplants, more biopsies may be done.