Percutaneous Liver Biopsy

A liver biopsy is a procedure to remove a small piece of liver tissue, so it can be examined under a microscope for signs of damage or disease. Your doctor may recommend a liver biopsy if blood tests or imaging techniques suggest you might have a liver problem. A liver biopsy also is used to determine the severity of liver disease. This information helps guide treatment decisions.

The most common type of liver biopsy is called percutaneous liver biopsy. It involves inserting a thin needle through your abdomen into the liver and removing a small piece of tissue. You will be sedated for the procedure. Ultrasound imaging is often used to visualize the liver during insertion of the needle.

What to expect

You will lie on your back with your right hand under your head. You need to stay as still as you can. The physician will find the correct spot for the biopsy needle to be inserted into the liver. This is often done by using ultrasound. You will receive sedating medication during this process. The skin is cleaned, and numbing medicine is injected into the area using a small needle. A small cut is made at spot, and the biopsy needle is inserted. The needle is removed quickly and the small sample of liver tissue is placed in a specimen container and sent to a pathologist for evaluation. A bandage is placed over the insertion site. You will then be moved to the recovery area. Typical time spent in the recovery area after a liver biopsy is 2 to 4 hours, after which you will be sent home to rest. Most people resume their usual activity the day following the test.

What can be found

A liver biopsy is used to evaluate for unexplained elevations in blood liver tests as well as abnormalities found during imagining tests, such as abdominal ultrasound or CT scan. A liver biopsy allows the pathologist to determine the amount of inflammation and scar tissue deposition in the liver. This is useful in evaluating conditions such as fatty liver disease / non-alcoholic steatohepatitis “NASH” and viral hepatitis, such as hepatitis C. The liver biopsy can provide information to determine the stage of the disease, can detect cancer or cirrhosis, and can provide prognostic information for a variety of conditions.

How to prepare

Notify your physician of any medications you are taking, particularly medications that affect the bloods ability to clot (“blood thinners”), any medication allergies, and bleeding problems, and if you are pregnant. Medications that affect the bloods ability to clot are usually held for a period before and after the liver biopsy. You will need to fast for the test (nothing to eat after midnight) and sign a consent form prior to the procedure. You will need to arrange to have someone drive you home, as the sedation for the procedure can linger.