Liver biopsy

  • Definition
    • A liver biopsy is a test that takes a sample of tissue from the liver for examination.

  • Alternative Names
    • Biopsy - liver; Percutaneous biopsy

  • How the Test is Performed
    • Most of the time, the test is done in the hospital. 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 the jugular vein.

      • If the procedure is performed this way, you will lie on your back.
      • X-rays will be used to guide the health care 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.

  • How to Prepare for the Test
    • Tell your health care provider about:

      • Bleeding problems
      • Drug allergies
      • Medicines you are taking
      • 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.

  • 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.

  • 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 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
  • Normal Results
    • The liver tissue is normal.

  • What Abnormal Results Mean
  • Risks
    • Risks may include:

      • Collapsed lung
      • Complications from the sedation
      • Injury to the gallbladder or kidney
      • Internal bleeding
  • References
    • Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, PA: Elsevier Saunders; 2010:section IX.

      Lomas DJ and Mannelli L. The liver and spleen. In: Adam A, Dixon AK, Gillard JH, Schaefer-Prokop CM, eds. Grainger & Allison's Diagnostic Radiology: A Textbook of Medical Imaging. 6th ed. New York, NY: Churchill Livingstone; 2014:chap 31.