Liver Biopsy

A liver biopsy is a procedure to remove a small piece of the liver so it can be examined with a microscope for signs of damage or disease. A liver biopsy is performed when a liver problem is difficult to diagnose with blood tests or imaging techniques, such as ultrasound and x ray. More often, a liver biopsy is performed to estimate the degree of liver damageā€”a process called staging. Staging helps guide treatment. Transvenous liver biopsy is used when a person's blood clots slowly or when excess fluid is present in the abdomen, a condition called ascites.

During the procedure, patients lie on their back on an x-ray table and a local anesthetic is applied to one side of the neck. If needed, an IV tube is used to give sedatives and pain medication.

A small incision is made in the neck and a specially designed hollow tube called a sheath is inserted into the jugular vein. The doctor threads the sheath down the jugular vein, along the side of the heart, and into one of the hepatic veins, which are located in the liver. To see the veins, the doctor injects liquid contrast material into the sheath. The contrast material lights up when x rayed, highlighting the blood vessels and showing the location of the sheath.

The doctor threads a biopsy needle through the sheath and into the liver and a liver sample is quickly withdrawn. Several samples may be collected, requiring multiple needle insertions. The sheath is carefully withdrawn and the incision is closed with a bandage.

Patients are monitored for 4 to 6 hours for signs of bleeding.

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