- 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
the procedures done by your gastroenterologist. It is said to have been
first performed by Paul Erlich in 1883. The basic technique has been
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
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
in the hospital for half a day. The doctor orders tests to check
and clotting times. Patient's blood group is known and blood available
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
seconds. This process is repeated and another specimen obtained. A
is applied and the patient lies on his/her right side for about 2 hours
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
the rest of the day resting at home. He/She should not be alone and
have easy access to a phone and a hospital.
Sometimes a liver biopsy is done by a Radiologist using an ultrasound or
scan to guide the needle(US or CT guided liver biopsy). In patients with
bleeding disorder it can be done by a catheter inserted into a neck vein
advanced into the liver (transjugular liver biopsy). Rarely it has to be
done via a tube inserted into the abdomen (laparoscopic liver biopsy).
Borland-Groover Clinic physician will be able to decide which technique
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
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
WHAT HAPPENS AFTER A LIVER BIOPSY?
The day after a liver biopsy the patient can resume his normal
Over the next week the liver specimen undergoes extensive evaluation
microscope by a pathologist skilled in liver diseases. Special stains
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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- 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
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