A liver biopsy is a procedure that is performed to remove a sample of the liver tissue. This is done by inserting a needle between two right lower ribs. The tissue sample that is taken is then sent to the lab and looked at under a microscope to detect if there is any liver problems.
A liver biopsy is generally done when the liver parameters in a blood test are abnormal. It can also be done when an ultrasound, CT scan, or x-ray shows an underlying problem with your liver. The biopsy is also performed to find out the root cause of diseases like jaundice, hepatitis, liver cancer, or cirrhosis.
A biopsy may also be ordered to:
- See how much your liver is scarred by diseases such as hepatitis
- To diagnose liver conditions such as Wilson’s disease and hemochromatosis
- Check if medicines such as methotrexate is having a toxic effect on your liver
- Check the health of a transplanted liver
- Find the cause of an ongoing fever
- Look for liver masses found on a CT scan or x-ray
A liver biopsy is generally performed by a hepatologist, gastroenterologist, radiologist, or a general surgeon in either a clinic or hospital. A radiologist uses an ultrasound or CT scan in order to guide the biopsy needle. When the doctor suspects that the patient has cancer or is suffering from cirrhosis of the liver, a liver biopsy may be performed during a laparoscopy.
How is the test done?
You will be asked to remove all your clothes and will be asked to change into a paper or cloth gown. You may be administered a sedative through an IV in your arm.
During the Test
You will be asked to lie on your back and extend your right arm resting either above or under your head and with your head turned to your left. Your doctor will tap on your chest and belly to check and find your liver or may use an ultrasound to conduct this test.
The doctor will next, mark the spot where the biopsy needle will be inserted. The area is then cleansed with a disinfectant and draped with sterile towels. You will be administered a local anesthetic in order to numb the area where the biopsy will go in.
You will be instructed to take a deep breath, and blow all the air out. You will then have to hold your breath until the needle is inserted. This will take barely a few seconds. You are asked to do this, as there are chances that the needle will go into your lungs as they are rather close to the liver. Once the needle is inserted it takes a few seconds for the doctor to collect the tissue sample. Once the needle is out you can breathe normally again. The whole procedure will take no longer than 30 minutes.
Once the procedure is completed, you will be asked to lie on your right side for about 2 to 6 hours, while your BP and temperature will be monitored.
If you do not develop any problems, you can go home after the test. You can also resume a regular diet, but will be asked to stay off aspirin, blood thinners, and nonsteroidal anti-inflammatory medications for at least one week after the biopsy. You will also be advised against indulging in any strenuous activities until the doctor gives you a green signal.