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Liver Biopsy

What is a liver biopsy?

A liver biopsy lets the doctor get a tiny piece of your liver to test (examine). The doctor examines this piece of liver under a microscope to find the cause of your liver disease and the amount of damage to your liver. Liver disease may result in abnormal liver tests or a change in liver size.

How is a liver biopsy used?

Illustration of a human with the liver illustratedIn many cases, the doctor can find the cause of your liver disease from the results of your blood tests. A liver biopsy confirms the cause and finds the amount of damage to the liver. If you have had a liver transplant, the doctor can use a liver biopsy to find the cause of abnormal liver tests and to see if the liver is being rejected. If you have a liver tumor, the doctor can learn more about the tumor by doing a liver biopsy.

How do I prepare for my liver biopsy?

Tell the doctor if you have a personal or family history of a bleeding disorder.

Do not take aspirin, aspirin substitutes or any products containing aspirin or salicylic acid for 10 days before the biopsy. Aspirin and medicines like aspirin (sometimes called NSAIDS) can increase the risk of bleeding after the biopsy. Examples are given below.

Do not take:

  • Advil
  • Aleve
  • Alka Selzter
  • Anacin
  • Ascriptin
  • Arthrotec
  • Bayer
  • BC Powder
  • Bufferin
  • Cataflam
  • Celebrex
  • Doan’s
  • Ecotrin
  • Equagesic
  • Excedrin
  • Goody’s
  • Ibuprofen
  • Indocin
  • Mobic
  • Motrin
  • Naprosyn
  • Norgesic
  • Nuprin
  • Voltaren

You may take Tylenol. Read the label carefully. Call the doctor if you have any doubts about a medicine. The biopsy may be postponed if you have taken an NSAID by mistake.

  • If you have not had blood work within 7 days prior to your biopsy, it will be done the morning of your biopsy.
  • Make sure an adult is with you who can take you home and stay with you after the biopsy, because you will NOT be able to drive yourself.
  • If your biopsy will be performed in the endoscopy unit, you may eat a small breakfast the morning of the biopsy. If you are being referred to Radiology for your biopsy, please do not eat or drink anything past midnight prior to your biopsy.
  • Tell your doctor if you have any reactions to medicines, or are allergic to iodine, lidocaine or band aids.
  • Use the bathroom right before the biopsy so you will not need to go too soon after the biopsy.

What will happen during my liver biopsy?

  1. The doctor examines the lower right side of your chest and stomach to find the best area for the biopsy.
  2. The area is cleaned with iodine and alcohol. Sterile paper towels are placed around the cleaned area.
  3. The area is made numb with lidocaine. This stings briefly.
  4. A tiny cut is made in your skin. You should not feel this.
  5. The doctor passes the biopsy needle quickly into and out of the liver through the cut. You may feel a pushing sensation or a pinch. Stop breathing when the doctor asks you to do so. Follow the doctor’s instructions during the biopsy.
  6. A band aid is placed over the cut. The biopsy is finished.

What will happen after my liver biopsy?

  1. After the biopsy, you will lie on your right side for an hour or two. This will put pressure on the biopsy site. You will be carefully watched during the next two to six hours. You will stay in bed and a nurse will check your pulse and blood pressure often. You may have some discomfort in your shoulder or neck. This should be mild and will go away in an hour or two. You may be given pain medication if needed.
  2. If a problem occurs, you will have to stay in the hospital. If there are no problems, you can go home two to six hours after the test (determined by the doctor). You will not be allowed to leave alone. An adult must take you home. You may not drive yourself.
  3. You should rest the day of the biopsy.

Over the next 24 hours...

  • You can return to your normal activities the next day.
  • Avoid playing sports.
  • No heavy lifting and straining for the next two days.

What are the risks of a liver biopsy?

  • The main risk of liver biopsy is bleeding from the spot where the needle entered your liver. This occurs in less than 1 of every 1000 patients.
  • Other problems include the puncture of other organs, such as the lung, gallbladder, kidney or colon.
  • Puncture of the liver itself can lead to the leakage of bile into the stomach cavity. This may cause pain that may last for a few hours, but it is rarely dangerous.

Call the doctor if you...

  • Have increasing pain, dizziness or trouble breathing.
  • Fever or chills.
  • Swelling or redness at the site of the liver biopsy.