Liver Biopsy

5The liver is the football-sized organ above your stomach and below your diaphragm. It's the body's largest solid organ, and because of the hundreds of functions it performs, it is also considered to be a gland.

A few of the functions the liver performs include:

  • creating bile that is necessary for the digestion of food
  • metabolizing proteins, fats and carbohydrates
  • storing essential vitamins and sugars
  • filtering the blood to remove harmful bacteria
  • producing amino acids used for fighting infections
  • converting waste products into urea to be excreted in the urine

Because the liver has so many functions, an injury to or disease in the liver can seriously damage the body. Generally, more than 75% of the liver has to be damaged before it begins to show failure in performing its functions. Therefore, we use live biopsies to remove a small piece of liver tissue that will be closely examined under a microscope to detect signs of disease or damage.

The procedure typically takes place in our office or a hospital setting. There are three main types of liver biopsies, and the steps are different for each.

The different types of liver biopsies include:

  • Percutaneous biopsy – The most common liver biopsy, the physician will either tap on the abdomen or use an ultrasound to locate the liver. The patient will lie on his/her back, placing the right arm above the head on the table. The area near the bottom of the rib cage is numbed with an anesthetic, and then a small incision is made. The biopsy needle is then inserted into the incision, the patient will hold his/her breath, and the sample will be taken. Stitches are used to close the incision.
  • Transjugular biopsy – The patient will lie on his/her back, and the neck area will be numbed with an anesthetic. A small incision is made, and a flexible plastic tube is inserted into the incision, threading into the jugular vein. The tube is then passed into the hepatic vein, a large vein in the liver. The physician injects a contrasting dye through the tube, which allows the hepatic vein to be visible on X-rays. After this vein is detected, a biopsy needle is pushed through the tube, and the liver sample will be taken. The tube is removed, and the incision will be bandaged.
  • Laparoscopic biopsy – This biopsy involves the patient being put under general anesthesia. On the operating table, the patient will lie on his/her back, and small incisions will be made in the abdomen. A tiny camera will be inserted through the incision, and a video will be projected onto monitors in the operating room. Using the video, the physician will direct many tools toward the liver in order to remove a sample. Afterward, all tools and the camera are removed, and the incisions are sealed with stitches.

After your biopsy, you will move to the recovery area for approximately two hours. Due to the sedatives used, someone will need to drive you home. During the next week, please do not lift items weighing more than 10-15 pounds. Over the course of the week, you can gradually resume your normal routine; however, you will likely feel sore where the needle was inserted for up to a week.