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What are the important functions of the liver?
A liver biopsy is a procedure that involves inserting a small needle into the liver to collect a tissue sample.
The liver is the body’s largest internal organ that performs multiple body functions.
The liver synthesizes the body's
- proteins,
- blood clotting factors,
- components of lipid (cholesterol),
- glycogen, and
- bile.
It also helps in the digestion process by producing enzymes. Because of the importance of the liver and its functions, it can regrow rapidly as long as it is kept healthy.
What can a liver biopsy diagnose?
A liver biopsy is a procedure that involves inserting a small needle into the liver to collect a tissue sample. The tissue is then analyzed in a lab to help the doctors diagnose a variety of disorders and diseases of the liver. A liver biopsy is usually performed to help identify the cause of liver ailments such as:
- Persistent abnormal liver blood tests (liver enzymes)
- Unexplained yellowing of the skin (jaundice)
- A liver abnormality found on ultrasound, computed tomography scan, or nuclear scan
- Unexplained enlargement of the liver
- Monitor the liver after a liver transplant
- Ongoing, unexplained fevers
A liver biopsy can also be used to estimate the degree of liver damage, grade and stage of hepatitis B and C, and determine the best treatment for the damage or disease.
How is a liver biopsy done?
There are several steps to a liver biopsy procedure:
- Liver biopsy is usually done under local anesthesia.
- The patient is asked to lie on their back, with their right elbow out to the side and right hand under the head. It is important that the patient remain as still as possible during the procedure.
- An ultrasound is used to mark the location of the liver.
- The doctor will clean an area on the upper abdomen, then make a small incision and insert a needle into this incision to take a small sample of liver tissue for analysis.
What are the other methods of liver biopsy?
Two other methods of liver biopsy include:
- Laparoscopic biopsy: During a laparoscopic biopsy, a laparoscope (a thin lighted tube with a camera attached) is inserted through an incision in the abdomen. The laparoscope sends images of the liver to a monitor that the doctor watches while using instruments to remove tissue samples from one or more parts of the liver. This type of biopsy may be used when tissue samples are needed from specific parts of the liver.
- Transverse biopsy: Transvenous biopsy may be done when patients have blood-clotting problems or fluid in the abdomen. The physician inserts a tube called a catheter into a vein in the neck and guides it to the liver. A biopsy needle is placed into the catheter and then into the liver to obtain a sample.
How painful is a liver biopsy?
Pain is the most common symptom observed after liver biopsy. It is usually experienced as a mild discomfort. Some patients may need narcotic pain medication, such as Tylenol (acetaminophen) with codeine.
What are the common complications of liver biopsy?
In most cases there are no complications from having a liver biopsy. A few individuals may experience:
- Internal bleeding
- Pain at the site
- Infections
- Leak of bile from the liver or gallbladder
- Pneumothorax (a serious complication where the needle pierces the lungs and cause breathlessness)