In a liver biopsy, a thin needle is inserted through the skin and into the liver. A small liver tissue sample is drawn and sent to the laboratory. The sample will be examined for signs of liver damage, scarring, or disease.
Liver biopsies may be necessary to diagnose liver problems when blood tests or imaging tests cannot provide conclusive information.
Percutaneous Liver Biopsy
Percutaneous liver biopsy is the most frequently used technique for collecting the liver sample. This test uses a hollow needle, inserted into the liver, to draw out a small sample of tissue.
Doctors use imaging techniques (such as ultrasound or CT) to watch the needle’s path and avoid inserting the needle into neighboring organs.
The patient’s abdomen will have local anesthetic applied. Sedatives and pain medication will be recommended as needed.
Transvenous Liver Biopsy
The Transvenous Liver Biopsy test is preferred when a patient’s blood clots slowly, or if the abdomen has excess fluid (a possible symptom of some liver diseases).
The doctor makes a small incision on the patient’s neck and a hollow tube is inserted into the jugular vein. The tube is guided into one of the hepatic veins (veins in the liver). In order to see the veins, liquid contrast material is injected into the tube. When x-rayed, the contrast material lights up and the doctor can follow the paths of the veins.
The patient’s neck will have local anesthetic applied. Sedatives and pain medication will be recommended as needed.
Laparoscopic Liver Biopsy
Laparoscopic Liver Biopsy tests can obtain liver tissue samples from one area or multiple areas – often needed if the chance exists of infection spreading.
Small incisions are made at each area being tested, usually below the rib cage. A plastic tube is inserted through the incisions and inflated with gas, giving the doctor space to work. The biopsy needle is inserted through the plastic tube to draw a small tissue sample. A small video camera can also be inserted, allowing the doctor to monitor any bleeding.
The patient’s treated areas will have local anesthetic applied. Sedatives and pain medication will be recommended as needed.