A liver biopsy is done using a needle inserted between two of the right lower ribs to remove a sample of liver tissue. The tissue sample is sent to a laboratory and looked at under a microscope to see if there are any liver problems.
A liver biopsy may be done when liver blood tests are abnormal. It may be done when an X-ray, an ultrasound, or a computed tomography (CT) scan shows a problem with the liver. A liver biopsy can also be done to find the cause of jaundice or to check on cirrhosis, hepatitis, or liver cancer.
A liver biopsy may be done to:
Before you have a liver biopsy, tell your doctor if you:
If you take insulin, check with your doctor about what you need to take on the day of your test.
You will be asked to sign a consent form that says you understand the risks of the test and agree to have it done.
Arrange for someone to drive you home after the test because you may be given a sedative to help you relax.
You will have blood tests done before the liver biopsy to see whether you have any bleeding or blood clotting problems. You may also have an ultrasound test or CT scan of the liver to check the best place to insert the biopsy needle.
Follow the instructions exactly about when to stop eating and drinking. If you don't, your procedure may be cancelled. If your doctor told you to take your medicines on the day of the procedure, take them with only a sip of water.
Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results will mean. To help you understand the importance of this test, fill out the medical test information form( What is a PDF document? ).
A liver biopsy is done by a gastroenterologist, hepatologist, radiologist, or surgeon in a clinic or a hospital. A liver biopsy is often done by a radiologist using ultrasound or a CT scan to help guide the biopsy needle. When cirrhosis of the liver or a cancer is suspected, a liver biopsy may be done during a laparoscopy.
You will need to take off all or most of your clothes. You will be given a cloth or paper gown to use during the test.
Before the test, you may be given a sedative through a vein (IV) in your arm. The sedative will help you relax and remain still.
During the test, you will lie on your back with your right arm resting under or above your head and your head turned to your left. Your doctor may tap on your chest and belly to find your liver or he or she may use ultrasound.
Your doctor will mark a spot between two of your right lower ribs where the biopsy needle will be inserted. The site will be cleaned with a special soap and draped with sterile towels. The doctor will give you a medicine (local anesthetic) to numb the area where the biopsy needle will be inserted.
You may be asked to take a deep breath, blow all the air out, and then hold your breath while the biopsy needle is being inserted and withdrawn. This will take only a few seconds. Holding your breath lowers the chance that the needle will go in your lung since the lungs are very close to the liver. It is important to remain still during the few seconds it takes for the doctor to collect the tissue sample. The doctor may take another tissue sample from the same spot, but from a different angle.
As soon as the doctor removes the needle, you can breathe normally. A bandage will be put on the puncture site. The test generally takes 15 to 30 minutes.
You will rest in bed and lie on your right side for 2 to 6 hours after the test. Your pulse, blood pressure, and temperature will be checked often after the biopsy.
You can go home if you have no problems after the test. You may eat your regular diet. But unless your doctor tells you it is okay, do not take aspirin, non-steroidal anti-inflammatory medicines, or blood thinners for one week after the biopsy. You may do your regular activities, but do not do strenuous activities or heavy lifting until your doctor says it is safe.
You may feel a brief sting or burn when the numbing medicine (anesthetic) goes in your skin. When the biopsy needle is inserted, you may again feel a sharp pain for a few seconds.
You may feel deep pressure and a dull pain in your belly when the biopsy needle is inserted. After the anesthetic wears off, you may feel a dull pain in your right shoulder. This is called referred pain and generally goes away in about 12 hours. You can take a non-prescription medicine, such as acetaminophen (Tylenol), for the pain. Call your doctor if your pain gets worse or lasts longer than 2 days.
A small amount of bleeding from the biopsy site can be expected. Ask your doctor how much drainage to expect.
Serious problems from a liver biopsy are rare. Problems can include:
After the test, call 911 or other emergency services immediately if you develop:
After the test, call your doctor immediately if you have:
Test results are generally ready in 2 to 4 days. If tests are done to find infections, it may take several weeks for the results to be ready.
The liver tissue looks normal under a microscope. No signs of infection, inflammation, cancer, or cirrhosis are present.
Abnormal cells or liver tissue are present. This may be caused by an infection such as hepatitis, liver disease such as cirrhosis, or cancer. If liver cancer is present, the biopsy can help find the type of cancer. If hepatitis is present, the test can be used to see the chance of developing cirrhosis. Test results may also show the severity of cirrhosis.
Occasionally, a liver biopsy may not provide helpful results because not enough tissue is sampled to make a clear diagnosis.
Other Works Consulted
Chernecky CC, Berger BJ (2013). Laboratory Tests and Diagnostic Procedures, 6th ed. St. Louis: Saunders.
Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.
Pagana KD, Pagana TJ (2010). Mosby's Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis: Mosby.
Current as ofJune 25, 2018
Author: Healthwise StaffMedical Review: E. Gregory Thompson, MD - Internal MedicineBrian O'Brien, MD, FRCPC - Internal MedicineAdam Husney, MD - Family MedicineMartin J. Gabica, MD - Family MedicineMichel M. Murr, MD - General Surgery, Bariatric Surgery
Current as of: June 25, 2018
E. Gregory Thompson, MD - Internal Medicine & Brian O'Brien, MD, FRCPC - Internal Medicine & Adam Husney, MD - Family Medicine & Martin J. Gabica, MD - Family Medicine & Michel M. Murr, MD - General Surgery, Bariatric Surgery
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