Liver Biopsy And Its Indication

One of the most useful body organs inside the body is the liver. Unfortunately, there are plenty of illnesses and diseases associated with liver. In diagnosing a number of liver diseases, a liver biopsy is often suggested. It is a diagnostic examination wherein a small sample of liver tissue is being removed for analysis. A liver biopsy can assess the severity of damage of the liver and monitor the progress of the treatment given in improving the health of the liver. This test is very vital in identifying the severity of the injury of the liver of those individuals who are affected with hepatitis. Also, it can also detect cancers, abnormalities, infections, and the reason of its enlargement. This has been one of the safest procedures, with approximately one in a thousand individuals experiencing serious complications from one. The first liver procedure was performed by the German physician Paul Ehrlich around 1833.

Indications of Liver Biopsy

Liver biopsy is often suggested to diagnose a liver problem. Also, it is suggested when hepatitis can be the possibly result of medication, other than the exact nature of the reaction is unclear. Tuberculosis and alcoholic liver disease of the liver can be diagnosed through liver biopsy. In addition, direct biopsy of detected tumors of the liver may assist the diagnosis, although it can be avoided if the source is clear. When the diagnosis is already clear, liver biopsy becomes useful in assessing the severity of the associated liver damage. These cases are also the same with hemochromatosis or iron overload, although it is often omitted. On the other hand, primary biliary cirrhosis and primary sclerosing cholangitis may also require biopsy. However, other diagnostic procedures have made it less necessary. Intermittently, liver biopsy is suggested in monitoring the development of treatment, such as viral hepatitis.

Several Approaches in Obtaining Sample Tissue

  • Percutaneous Liver Biopsy – In this procedure, the doctor will use a local anesthesia to numb the skin in creating a small incision. A needle is inserted through the skin reaching the liver, where the doctor obtains the specimen. In this situation, the doctor institutes the location of the liver by percussing the skin that overlies the liver and listening to the sound created to search for an area of dullness. This is where the liver often lies. Patient’s cooperation is very vital while the procedure is going on.
  • Percutaneous Image-Guided Liver Biopsy – this procedure is quite similar to percutaneous liver biopsy. However, this procedure uses needle that is guided by CT scan or ultrasound images. This is usually helpful when the condition of the disease is contained in the discrete spots of the liver.
  • Laparoscopic liver biopsy – This procedure can be done safely for the purpose of acquiring the biopsy specimen, or it could be another part of another operative procedure. Small incisions are created in the abdomen, and instruments are often introduced using trocars in obtaining the biopsy specimens. A laparoscope is a type of telescope that amplifies the objects it views, allowing perfect visualization of the liver surface. Ultrasound can also be utilized as a part of the procedure.
  • Open Surgical Liver Biopsy – This procedure is rarely performed at present unless they are included in an operative procedure. When an open biopsy is performed, the surgeon may prefer to use a biopsy needle or can be surgically expunge a small wedge of the liver tissue.

What to expect during the procedure

Upon performing the procedure, the blood samples are usually taken to ensure that the blood is properly clotting. Inform the doctor about the medications that are regularly taken, especially if they are blood thinners. A week before biopsy, patients are told to stop taking ibuprofen, aspirin and other medications that have an anticoagulant property.

Liver biopsy is often considered as a minor surgery, thus it can be done when the patient is awake. Patients are usually told not to drink or eat anything for eight hours before liver surgery. An intravenous fluid line is connected to provide an access in administering sedatives and pain killers. Once the patient is in position, the physician will create a small incision on the right side to insert the biopsy needle. The needle will extract a sample and the incision area will be covered with a bandage. The patient is advised to lie on the right side for a period of time. After the liver biopsy, the patient will be instructed to stay in bed up to twelve hours for resting.