Definition

A liver biopsy removes a sample of liver tissue for testing.

Reasons for Procedure

This procedure is done to find the cause of problems with the liver, such as liver disease, cancers, and infection

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Excess bleeding
  • Problems from anesthesia, such as wheezing and sore throat
  • Infection
  • Damage to nearby organs

Things that may raise the risk of problems are:

What to Expect

Prior to Procedure

The surgical team may meet with you to talk about:

  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before
  • Arranging for a ride to and from surgery
  • Tests that will need to be done before surgery, such as imaging tests

Anesthesia

You may be given:

Description of the Procedure

There are three ways a liver biopsy is done:

  • Traditional liver biopsy
  • Laparoscopic liver biopsy—to take a biopsy from a specific area of the liver
  • Transvenous liver biopsy—to take a biopsy in someone whose blood does not clot well or who has a lot of fluid in the belly

Traditional Liver Biopsy

A small incision will be made near your ribs. An ultrasound or CT scan may be used to help guide the a needle. You will need to exhale and hold your breath while the needle is inserted. This may need to be done more than once. The needle and sample will be removed. A bandage will be put on the incision.

Liver Biopsy
Placement of Liver Biopsy Needle

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Laparoscopic Liver Biopsy

A tiny incision will be made. A long tool with a camera on the end will be passed into the belly near the liver. More incisions will be made to pass other tools. These tools will be used to remove samples of the liver. The tools will be removed. A bandage will be put over the incision.

Transvenous Liver Biopsy

A tiny flexible tube will be threaded into a vein in the neck or groin. This tube will be threaded into the veins in the liver. A needle will be passed through the tube to get a sample. The tube and needle will be removed.

Immediately After Procedure

You will lie on your right side for at least two hours.

How Long Will It Take?

About 15 to 20 minutes

Will It Hurt?

Pain and cramping at the biopsy site are common in the first few hours or days. You may also have pain in the right shoulder.

Average Hospital Stay

Most people can go home the same day. If there are problems, you may need to stay longer.

Postoperative Care

At the Care Center

Right after the procedure, the staff may give you medicine to treat pain.

During your stay, staff will take steps to lower your chance of infection, such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

You can also lower your chance of infection by:

  • Washing your hands often and reminding visitors and staff to do the same
  • Reminding staff to wear gloves or masks
  • Not letting others touch your incisions

At Home

Activities will need to be limited for a few days. The biopsy results will take 1 to 4 weeks to get back. You and your doctor will discuss the results.

Call Your Doctor

Call the doctor if you are not getting better or you have:

  • Signs of infection, such as fever and chills
  • Redness, swelling, more pain, a lot of bleeding, or any discharge from the incision
  • Severe belly pain, nausea, or vomiting
  • Lightheadedness
  • Severe shoulder pain
  • Trouble breathing, cough, or chest pain

If you think you have an emergency, call for medical help right away.

RESOURCES:

American Liver Foundation
https://www.liverfoundation.org

National Institute of Diabetes and Digestive and Kidney Diseases
https://www.niddk.nih.gov

CANADIAN RESOURCES

Canadian Liver Foundation
https://www.liver.ca

Health Canada
https://www.canada.ca

REFERENCES:

Diagnosing liver disease—liver biopsy and liver function tests. American Liver Foundation website. Available at: https://liverfoundation.org/for-patients/about-the-liver/the-progression-of-liver-disease/diagnosing-liver-disease/. Accessed August 14, 2020.

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. Accessed August 14, 2020.

National Institute for Health and Care Excellence guideline on non-alcoholic fatty liver disease, assessment and management. NICE 2016 Jul:NG49.

Nonalcoholic fatty liver disease (NAFLD). EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/nonalcoholic-fatty-liver-disease-nafld. Accessed August 14, 2020.

Last reviewed March 2020 by EBSCO Medical Review Board James P. Cornell, MD  Last Updated: 8/14/2020