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Liver Biopsy

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    LIVER BIOPSY What is a Liver Biopsy? Who needs a liver biopsy? How is a Liver Biopsy done? What are the risks associated with a Liver Biopsy? What happens
    Message 1 of 48 , Jan 17, 2000
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      LIVER BIOPSY

      What is a Liver Biopsy?
      Who needs a liver biopsy?
      How is a Liver Biopsy done?
      What are the risks associated with a Liver Biopsy?
      What happens after a Liver Biopsy?

      WHAT IS A LIVER BIOPSY?

      A liver biopsy is a procedure by which a thin core of liver tissue is
      obtained for analysis under a microscope. It is probably the oldest of
      all
      the procedures done by your gastroenterologist. It is said to have been
      first performed by Paul Erlich in 1883. The basic technique has been
      refined
      since then. These refinements have decreased the risk to a degree that a
      liver biopsy is commonly done on an outpatient basis.

      WHO NEEDS A LIVER BIOPSY?

      Since liver biopsy is considered the "gold standard" its indications are
      many and varied. The clinician uses the information obtained to guide
      his
      treatment or assess the extent and severity of liver damage. Some of the
      more common indications are:

      a.Chronic viral hepatitis like Hepatitis B and Hepatitis C.
      b.Unexplained liver enlargement and liver tests.
      c.Alcohol induced liver disease.
      d.Drug induced liver damage.
      e.Space occupying liver lesions like tumors and cancers.
      f.Systemic diseases and infections affecting the liver.
      g.After liver transplantation for rejection and other complications.
      h.Assessment of response to treatment.
      i.Storage diseases of the liver.

      HOW IS A LIVER BIOPSY DONE?

      Most liver biopsies are done on an outpatient basis i.e. the patient
      stays
      in the hospital for half a day. The doctor orders tests to check
      bleeding
      and clotting times. Patient's blood group is known and blood available
      if
      needed. All recent medications are reviewed. Aspirin and aspirin like
      medications should have been stopped. Under full aseptic precautions the
      right side of the chest is cleaned and numbed using local anesthesia.
      Breathing techniques are practiced with the patient. Using a long fine
      needle a core of liver tissue is obtained. The actual process takes only
      1-2
      seconds. This process is repeated and another specimen obtained. A
      dressing
      is applied and the patient lies on his/her right side for about 2 hours
      and
      on the back for another 2 hours. After about 4-6 hours a blood sample is
      drawn. If this sample is similar to the one drawn before the biopsy, no
      bleeding has occurred and the patient is discharged home. The patient
      spends
      the rest of the day resting at home. He/She should not be alone and
      should
      have easy access to a phone and a hospital.

      Sometimes a liver biopsy is done by a Radiologist using an ultrasound or
      CT
      scan to guide the needle(US or CT guided liver biopsy). In patients with
      a
      bleeding disorder it can be done by a catheter inserted into a neck vein
      and
      advanced into the liver (transjugular liver biopsy). Rarely it has to be
      done via a tube inserted into the abdomen (laparoscopic liver biopsy).
      Your
      Borland-Groover Clinic physician will be able to decide which technique
      is
      best for you.

      WHAT ARE THE RISKS ASSOCIATED WITH A LIVER BIOPSY?

      A liver biopsy is by and large a safe procedure. The risk of dying is
      about
      1 in 10,000 procedures. The various reported complications are.

      a.Bleeding: This is an uncommon but serious complication. It is
      usually controlled by observation and blood
      transfusion, but may require surgery to stop it.
      b.Injury to the Gallbladder.
      c.Bleeding into the bile ducts.
      d.Injury to the kidney and colon.
      e.A connection between a vein and an artery called a fistula.
      f.Irritation of the covering of the lung or liver (Pleurisy or
      perihepatitis).

      WHAT HAPPENS AFTER A LIVER BIOPSY?

      The day after a liver biopsy the patient can resume his normal
      lifestyle.
      Over the next week the liver specimen undergoes extensive evaluation
      under a
      microscope by a pathologist skilled in liver diseases. Special stains
      (dyes)
      are used to highlight various aspects of the liver. This result is made
      available to your gastroenterologist who uses this information for
      diagnosis, treatment decisions and to assess the prognosis.

      (Thanks to Sheree)

      Dr Sharat C Misra MD, DM
      Consultant Gastroenterologist & Hepatologist
      Each morning is the doorway to a new world,
      A beginning of infinite possibilities.
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    • w.m.landstra
      Hi.Forgot to give my humble advise regarding treatment and your job.Don.t say anything to your boss,see how treatments goes first.Willem [Non-text portions of
      Message 48 of 48 , Jul 23, 2003
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        Hi.Forgot to give my humble advise regarding treatment and your job.Don.t say anything to your boss,see how treatments goes first.Willem


        [Non-text portions of this message have been removed]
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