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Liver biopsy

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Overview of liver biopsy

A liver biopsy is a procedure to remove a small piece of the liver so it can be examined with a microscope to help diagnose a liver disease, to ascertain the severity of known liver disease, and to determine the effect of medication and treatment. Liver biopsy is generally necessary when imaging and physical tests detect a serious liver problem. 

Techniques of liver biopsy have evolved over the years but what has stayed the same is that the procedure aims to obtain a piece of the liver for examination.

Percutaneous – This is the most common form of liver biopsy and is often done by a radiologist. Imaging techniques like ultrasound or a CT scan is used to guide the needle which aims to remove a small part of the liver for examination. This kind of biopsy provides real time image, reduces the risk of complications and also is suitable on a wide range of patients with liver ailments.

Laparoscopic or open biopsy – This is a more elaborate process compared to needle biopsy and is done under general anesthetic. This method is used when a percutaneous procedure may not be possible or available. It is, however, helpful as it provides a better view of the liver and allows the doctor to determine which part of the liver he may want a biopsy of.

Transvenous biopsy – A more complex and delicate form of biopsy this method is done under local anesthetic. Normally the femoral route is undertaken for this approach and the process is quite similar after that where a needle is guided by the radiologist to take a sample of the liver. A less popular method of biopsy, it also uses imaging devices like ultrasound and CT for help.


Reasons for the procedure

Liver biopsy is often used to diagnose the reasons behind a liver disease. It can also be used to determine cases of  

  • Liver tumors
  • Hepatitis
  • Alcoholic liver disease
  • Fatty liver
  • After liver transplant to determine if the liver has been rejected by the body.  


Preparing for liver biopsy

Anyone schedule for a liver biopsy may have to discontinue certain mediations. Medicines like aspirin and other over the counter drugs like ibuprofen, naproxen, advil amongst other should be avoided. A doctor may also want to conduct a minor test for blood clotting and advise you to go off any blood thinners that you maybe having. The doctor will also ask you to discontinue any high blood pressure medication, diabetes medications, antidepressants, medicines for allergies, antibiotics amongst others. While a light breakfast is advised on the day of the biopsy, patients who are placed under general anesthetics should not eat or drink water at least 8 hours before the liver biopsy. 


Recovery and results

Recovery from a biopsy happens fast and in almost all cases patients fully recover from a liver biopsy in 1 to 2 days. Patients are advised rest and should avoid strenuous activities, intense exercise, or heavy lifting for about two days. Tenderness, pain and a tingling sensation may remain around the incision site for about a week and a doctor may also want to observe you over a night. It takes a few days to get the results from a liver biopsy. A liver tissue sample goes through a process called staining that helps the pathologist ascertain a liver disease. 


Risks for liver biopsy

Pain at the biopsy site is the most frequent risk of percutaneous liver biopsy. There is also a risk of excessive bleeding, in the form of hemorrhage. Other risks include puncture of other internal organs, infection, and spread of cancer cells, called cancer seeding. Transvenous liver biopsy also has a risk of adverse reaction to the contrast material. 


Alternatives for liver biopsy

Patented by Echosens a new technique called Vibration-Controlled Transient Elastography or FibroScan (FS) is in vogue nowadays. According to the company it is used for the non-invasive measurement of liver stiffness, which is an effective marker of the quality of the hepatic parenchyma. The harder the liver, the greater the extent of the fibrosis. 

FS is easier to perform as it takes only about 10 minutes, safer and less expensive in comparison to a liver biopsy. Measurements with the FS can be taken at multiple locations of the liver whereas a liver biopsy tissue sample is taken from one location in the liver.

Written by: healthplus24 team
Date last updated: August 21, 2013