Liver biopsy
Biopsy - liver; Percutaneous liver biopsy; Needle biopsy of liverA liver biopsy is a test that takes a sample of tissue from the liver for examination.
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How the Test is Performed
Most of the time, the test is done in the hospital or specialized procedure unit. Before the test is done, you may be given a medicine to prevent pain or to calm you (sedative).
The biopsy may be done through the abdominal wall:
- You will lie on your back with your right hand under your head. You need to stay as still as you can.
- The health care provider will find the correct spot for the biopsy needle to be inserted into the liver. This is often done by using ultrasound.
- The skin is cleaned, and numbing medicine is injected into the area using a small needle.
- A small cut is made, and the biopsy needle is inserted.
- You will be told to hold your breath while the biopsy is taken. This is to reduce the chance of damage to the lung or liver.
- The needle is removed quickly.
- Pressure will be applied to stop the bleeding. A bandage is placed over the insertion site.
The procedure can also be done by inserting a needle into your liver by moving it through the jugular vein.
- If the procedure is performed this way, you will lie on your back.
- X-rays will be used to guide the provider to the vein.
- A special needle and catheter (thin tube) is used to take the biopsy sample.
If you receive sedation for this test, you will need someone to drive you home.
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How to Prepare for the Test
Tell your provider about:
- Bleeding problems
- Drug allergies
- Medicines you are taking including herbs, supplements, or medicines you bought without a prescription
- Whether you are pregnant
You must sign a consent form. Blood tests are sometimes done to test your blood's ability to clot. You will be told not to eat or drink anything for the 8 hours before the test.
For infants and children:
The preparation needed for a child depends on the child's age and maturity. Your child's provider will tell you what you can do to prepare your child for this test.
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How the Test will Feel
You will feel a stinging pain when the anesthetic is injected. The biopsy needle may feel like deep pressure and dull pain. Some people feel this pain in the shoulder.
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Why the Test is Performed
The biopsy helps diagnose many liver diseases. The procedure also helps assess the stage (early, advanced) of liver disease. This is especially important in hepatitis B and C infection.
The biopsy also helps detect:
- Cancer
- Infections
- The cause of abnormal levels of liver enzymes that have been found in blood tests
- The cause of an unexplained liver enlargement
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Normal Results
The liver tissue is normal.
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What Abnormal Results Mean
The biopsy may reveal a number of liver diseases, including cirrhosis, hepatitis, or infections such as tuberculosis. It may also indicate cancer.
This test also may be performed for:
- Alcoholic liver disease (fatty liver, hepatitis, or cirrhosis)
- Amebic liver abscess
- Autoimmune hepatitis
- Biliary atresia
- Chronic active hepatitis
- Chronic persistent hepatitis
- Disseminated coccidioidomycosis
- Hemochromatosis
- Hepatitis B
- Hepatitis C
- Hepatitis D
- Hepatocellular carcinoma
- Hodgkin lymphoma
- Non-alcoholic fatty liver disease
- Non-Hodgkin lymphoma
- Pyogenic liver abscess
- Reye syndrome
- Sclerosing cholangitis
- Primary biliary cholangitis
- Wilson disease
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Risks
Risks may include:
- Collapsed lung
- Complications from the sedation
- Injury to the gallbladder or kidney
- Internal bleeding
References
Holmes JA, Chung RT. Hepatitis C. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 80.
Martin P. Approach to the patient with liver disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 137.
Paradis V, Zucman-Rossi J. Cellular and molecular techniques. In: Burt AD, ed. MacSween's Pathology of the Liver. 8th ed. Philadelphia, PA: Elsevier; 2024:chap 2.