Percutaneous Liver Biopsy in New Orleans, LA

Before your liver biopsy, your provider will need to test your blood to determine how well it clots. It is important for your blood to clot properly after the biopsy to prevent excessive bleeding from occurring. All medications that can increase the risk of bleeding should not be taken. These medications include aspirin, aspirin-containing compounds, or other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (eg, Motrin® and Advil®), naproxen (eg, Aleve®), blood-thinners like warfarin (Coumadin®), certain medications for those with heart conditions such as abciximab (Reopro®), dipyridamole (Persantine®), ticlopidine (Ticlid®), and clopidogrel (Plavix®), and some natural therapies (like fish oil or ginkgo biloba). NSAIDs are often found in many OTC medications, so it is possible that you may take them without knowing. To ensure you are not taking anything that could put you at risk, share a complete list of any over-the-counter medications you are taking with your provider so they can instruct you on when to stop taking them to ensure a safe biopsy procedure.

Generally, you will have an ultrasound performed on your liver and gallbladder so your provider can confirm the most appropriate location for the biopsy to take place. You will not feel any pain or discomfort during the ultrasound as this machine only uses sound waves to gain visualization of our liver and other organs.

Your provider will give you specific instructions on how to best prepare for the biopsy. These instructions can vary to include not eating or drinking anything after midnight or they may instruct you to have a light breakfast. Some providers recommend a small portion of butter or margarine with breakfast, which can remove the contents from the gallbladder making injury less likely.

Sedation medication may be used during the biopsy, so you will need to arrange for someone to transport you home following the procedure. They can also keep you company during the recovery period after the procedure while our staff monitors your condition. Although patients with primary sclerosing cholangitis are often given antibiotics to lessen their risk of infection, most patients do not require antibiotics before a liver biopsy.

For further information on how to best prepare for your percutaneous liver biopsy in New Orleans, LA, we encourage you to contact your provider.

Generally, when you have a percutaneous liver biopsy, you will arrive for your procedure early in the morning. You will then review your medical history with a nurse or your provider, where you will need to disclose the medications you are taking along with any allergies you may have. At that point, an IV line is placed so that fluids and medications can be administered when needed. You will feel a slight prick when the intravenous line is placed, similar to the feeling of having blood taken. The procedure will be reviewed with you by your provider where you will discuss the reason for the biopsy, possible risks, and alternatives. If you have any questions about the procedure, your provider will be able to answer your questions during this time. Sedation medication may be used to reduce your discomfort and anxiety during the procedure, however, since a biopsy requires your cooperation, it is best to perform the procedure without sedation.

When you enter the procedure room, you will be asked to lay on your back towards the right edge of the examination table. Your provider will begin percussing, or tapping, against the side of your chest while you exhale and hold your breath to locate the ideal spot for your biopsy. This spot will then be marked by your provider to identify the biopsy site. After the site has been marked, alcohol and iodine solution will be used to prep your skin and the entire area will be draped in sterile towels. You will experience a burning sensation while local anesthesia is administered. Your provider will then create a small incision to allow the biopsy needle to travel through the skin with ease.

Before the biopsy, your provider may practice controlled breathing with you. You will be asked to breathe in and exhale completely and then hold your breath while your provider counts to four. This exercise will ensure that during the procedure your provider will be able to perform the biopsy at “end-expiration.” When you exhale completely, your right lung becomes smaller and your liver rises toward the chest. Performing this procedure during end-expiration (when you have completely breathed out), helps to reduce the risk of injury that the biopsy needle may cause to other organs surrounding the liver. It is extremely important that you follow the breathing instructions of your specialist to ensure that your biopsy is as safe and successful as possible.

The actual removal of liver tissue is very fast. It takes approximately one second for the biopsy needle to pass into the liver, remove a small sample of tissue, and come back out again. Automated liver biopsy devices are sometimes used by specialists. When these devices are used, a clicking noise occurs when the needle is deployed. After the biopsy, you will be told to resume breathing and a small bandage will be placed on the incision site. You will be instructed to remain on your right side for two hours for recovery. This can help to decrease the risk of any bleeding by administering pressure against the biopsy site.