This is a procedure to obtain a sample of liver tissue.
Reasons for Procedure
Biopsies of the liver are usually done to evaluate:
- Abnormal blood tests such as elevated liver enzymes, bilirubin, copper, or iron in the blood
- An enlarged liver
- The severity of liver diseases
- The progress of therapy for liver diseases
- A liver mass
- The liver after a liver transplant
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
- Perforation of the gallbladder or intestines
- Puncture of the lung
Factors that may increase the risk of complications include:
What to Expect
Prior to Procedure
Your doctor may do the following:
- Physical exam
- Blood tests
Before your biopsy:
- Avoid eating or drinking for 8-12 hours.
- Talk to your doctor about your medications. You may be asked to stop taking some medications up to 1 week before the procedure.
- Arrange for someone to drive you home after the biopsy.
If local anesthesia is used, then only the area that is being operated on is numbed. It is given as an injection and may also be given with a sedative.
Description of the Procedure
There are different techniques used to do a liver biopsy, including:
- Conventional liver biopsy
- Laparoscopic liver biopsy—done when the biopsy needs to be taken from a specific area of the liver
- Transvenous liver biopsy—done if blood clots poorly or there is a lot of fluid in the abdomen
Conventional Liver Biopsy
You will lie on your back with your right hand behind your head. An ultrasound or CT scan may be used to help guide the placement of the needle. The skin will be cleaned. Next, medication will be injected to numb the area. A small incision will be made. You will need to exhale and hold your breath while the needle is inserted. Sometimes, the needle will need to be inserted several times. After the procedure, the area will be bandaged.
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Laparoscopic Liver Biopsy
Your doctor will make a tiny incision. A long tool with a camera on the end will be passed into your abdomen in the area of the liver. It will send images of the liver to a TV screen. Additional incisions will be made to pass other tools. These tools will be used to remove samples of the liver.
Transvenous Liver Biopsy
A tiny flexible tube will be threaded into a vein in the neck or groin. This tube will be threaded all the way into the veins in the liver. A biopsy needle will be passed through the tube to get a biopsy sample.
Immediately After Procedure
You will lie on your right side for at least 2 hours.
How Long Will It Take?
About 15-20 minutes
Will It Hurt?
You will have mild pain or cramping at the biopsy site. You may also have pain in the right shoulder. The pain should last for less than 30 minutes.
Rest and avoid driving for at least 24 hours after the surgery. You may have to restrict certain activities, such as heavy lifting, until your doctor says it is okay to do so. Unless otherwise advised, resume a normal diet.
The biopsy results will take 1-4 weeks. You and your doctor will discuss the results.
Call Your Doctor
Call your doctor if any of these occur:
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
- Severe abdominal pain, nausea, or vomiting
- Severe shoulder pain
- Trouble breathing, cough, or chest pain
If you think you have an emergency, call for emergency medical services right away.
American Liver Foundation
National Institute of Diabetes and Digestive and Kidney Diseases
Liver biopsy. American Liver Foundation website. Available at: https://www.liverfoundation.org/for-patients/about-the-liver/the-progression-of-liver-disease/diagnosing-liver-disease. Accessed April 4, 2018.
Liver biopsy. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/diagnostic-tests/liver-biopsy. Updated May 2014. Accessed April 4, 2018.
6/2/2011 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T905141/Treatment-for-tobacco-use: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.
Last reviewed March 2018 by EBSCO Medical Review Board Daus Mahnke, MD Last Updated: 5/8/2014