A liver biopsy is a test for suspected liver disease where a tissue sample is taken for laboratory testing.
The biopsy may be done using a needle through the skin or with surgical techniques.
A liver biopsy helps doctors diagnose a variety of disorders and diseases of the liver. A liver biopsy is most often performed to help identify the cause of:
- Persistent abnormal liver blood tests (liver enzymes).
- Unexplained yellowing of the skin ( jaundice).
- A liver abnormality found by an ultrasound, CT (computerised tomography) or nuclear scan.
- Unexplained enlargement of the liver.
Is a liver biopsy safe?
In most instances, there are no complications in obtaining a liver biopsy. However, in rare cases internal bleeding may occur, as well as leakage of bile from the liver or gallbladder.
How do I prepare for a liver biopsy?
When preparing for a liver biopsy, there are several things to keep in mind:
- Tell your doctor if you're pregnant, have a lung or heart condition, are allergic to any medications, or have bleeding problems.
- Tell your doctor if you are taking blood-thinning medications such as warfarin, clopidogrel or dipyridamole. Your doctor may prescribe an alternative method of thinning your blood before the procedure.
- For a week before the procedure, do not take aspirin, products containing aspirin, or anti-inflammatory medicines such as ibuprofen, unless advised by your doctor that it is safe to do so.
Do not stop taking any medication without first consulting with your doctor or specialist.
What happens on the day of a liver biopsy?
Laboratory tests will be performed on the day of a liver biopsy or two to three days before the procedure, as directed by your doctor. These tests may include a blood count, a platelet count and a measurement of your blood's ability to clot.
Before the procedure:
- A doctor will explain the biopsy procedure in detail, including potential complications, and will answer any questions you may have.
During the procedure:
- You will lie on your back. It is important that you remain as still as possible during the procedure.
- An ultrasound scan may be used to mark the location of your liver and guide the point for needle insertion.
- You may receive a small dose of a sedative just before the procedure.
- The doctor cleans an area on your upper abdomen and numbs this area with a local anaesthetic. The doctor then makes a small incision in the skin over the liver and inserts a needle into the liver to take a small sample of liver tissue for analysis.
- The procedure takes about five minutes.
After the procedure:
- You will be observed for several hours to make sure there is no bleeding.
- You may feel minor discomfort or a dull pain in your shoulders or back. If necessary, you will be prescribed a pain medication.
- Do not drive or operate machinery for at least eight hours after the procedure.
- Avoid taking aspirin, products containing aspirin, or anti-inflammatory medicines such as ibuprofen for one week after the procedure. If your doctor agrees, you may take paracetamol if needed.
- Avoid vigorous physical activity for at least 24 hours after the biopsy.
- Your doctor will discuss the biopsy results with you several days after the procedure.