Liver Biopsy

What is a liver biopsy?
A liver biopsy is a procedure that involves obtaining a small piece of liver tissue, which is then analyzed in the laboratory. It is usually done to gain information about the liver, which cannot be obtained through blood tests. Please discuss the specific reason why you are having this done with your doctor.

How do I prepare for the biopsy?
During the consultation with your doctor, some blood samples would have been drawn to make sure your blood clots properly. Please make sure you mention all medications you take to your doctors, especially blood thinners.

One week prior to the biopsy, please stop all:

  • Blood thinners, such as coumadin.
  • Anti-platelet agents
  • Aspirin containing medications.
  • Other nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen (e.g., Motrin®, Advil®), and naproxen (e.g., Aleve®). NSAIDs are contained in a variety of over-the-counter preparations.
  • Certain medications for people with heart conditions (such as abciximab [Reopro®], dipyridamole [Persantine®], ticlopidine [Ticlid®], and clopidogrel [Plavix®]).
  • Some herbal therapies (such as fish oil or ginkgo biloba).

Do not eat or drink anything for 6 hours prior to your appointment. You can take your routine medications with small quantity of water.

You will need someone to drive you home since you cannot drive after the procedure. You will also need to take the day off and rest at home.

What to expect at the Surgery Center?

  1. Once you are checked in, your vital signs such as heart rate and blood pressure will be taken.
  2. The nurse will go over your medical history and your medications. She/he will also make sure that you are not taking any blood thinners. Please bring all your medications to show the nurse.
  3. An IV will be placed in case it becomes necessary to give you fluids or other medications.

How is the biopsy done?
You will be asked to lie on a couch on your back. An ultrasound scan is performed at the bedside to accurately locate the biopsy site. The scan is painless. The skin over the liver is then cleaned with antiseptic. (Your liver lies under your ribs and diaphragm, on the upper right hand side of your abdomen.)

Some local anesthetic is then injected into a small area of skin and tissues just over a part of the liver (usually between two lower ribs on the right hand side). This stings a little at first, but then makes the skin numb.

A small (few millimeters) cut is made and a special hollow needle is then pushed through the skin into the liver. Because of the local anesthetic, you should not feel any pain. However, you may feel some pressure as the doctor pushes on the needle.

You will have to hold your breath for 5-10 seconds when the needle is quickly pushed in and out (you will be told exactly when). This is because the liver moves slightly when you breathe in and out. As the needle comes out it brings with it a small sample of liver tissue. The needle itself will stay in the liver for only about a second.

What are the risks?
As with any biopsy procedure, there is a small chance of bleeding, infection, pain and damage to surrounding organs. In rare cases you may need to be observed in the hospital.

What happens after the procedure?
You will need to be in the recovery area for about 2 hours. You will be closely monitored during that period. If everything goes smoothly, you will be transported to your car in a wheelchair.

What about after discharge?

  • You should not drive for 24 hours.
  • No heavy lifting or strenuous exercise for 3 days.
  • No blood thinners, anti-platelet agents, aspirin, Plavix or NSAIDs for one week.
  • You may return to work the next day for a desk job or after 3 days for a strenuous job.