Liver Biopsy

Note: The information below is a general guide only. The arrangements, and the way tests are performed, may vary between different hospitals and doctors. Always follow the instructions given by your local hospital or doctor relating to any test or procedure.

What is a liver biopsy?

A biopsy is when a small sample of tissue is removed from a part of the body. The sample is looked at under a microscope, or tested in other ways. A liver biopsy is a common procedure when a small sample of liver tissue is removed. A liver biopsy is done to diagnose and monitor certain conditions of the liver. For example, cirrhosis, some metabolic liver disorders, or inflammation of the liver (hepatitis) which can be due to various causes.

How is it done?

You will be asked to lie on a couch on your back, or on your left side. The skin over the liver is cleaned with antiseptic. (Your liver lies under your ribs and diaphragm, on the upper right hand side of your abdomen.)

Some local anaesthetic is then injected into a small area of skin and tissues just over a part of the liver (usually between two lower ribs on the right hand side). This stings a little at first, but then makes the skin numb.

A special hollow needle is then pushed through the skin into the liver. Because of the local anaesthetic, you should not feel any pain. However, you may feel some pressure as the doctor pushes on the needle.

You will have to hold your breath for 5-10 seconds when the needle is quickly pushed in and out (you will be told exactly when). This is because the liver moves slightly when you breathe in and out. As the needle comes out it brings with it a small sample of liver tissue.

The doctor who does the biopsy may use an ultrasound scanner for guidance. The ultrasound scan locates the exact site of the liver so the biopsy needle is inserted at exactly the right place. The scan is painless.

What preparation is needed before a liver biopsy?

You will usually have a blood test done shortly before the biopsy to check how well your blood will clot. This is to make sure that you are not likely to bleed following the biopsy. You may be advised not to take any medicines that affect blood clotting such as aspirin and warfarin for one week before the biopsy. (You may need to discuss your medication with your doctor if you take such medicines for other conditions.)

You will need to sign a consent form at some point before the procedure to say that you understand what it involves, and the small risk.

What are the risks of liver biopsy?

Complications are uncommon. In a small number of cases there is some bleeding from the biopsy site. This is usually minor, and soon stops. Occasionally, the bleeding is more severe, and rarely it requires a blood transfusion and/or an operation to deal with it. The main reason you are monitored for several hours after the biopsy is to check for bleeding. A rare complication is for bile to leak from the liver internally. There is a small risk that the small wound will become infected after the biopsy.

After a liver biopsy

You will need to lie on a bed and be observed for several hours to check that you have no bleeding. Therefore, you may wish to bring in a book or an mp3 player for this time. If you come into hospital for the test, you may need to stay in overnight. However, if the biopsy was done early in the morning, you may be able to go home later in the day. You may have some discomfort which is usually eased with painkillers. The result of the biopsy may take a week or so to come back.

© EMIS and PIP 2006   Updated: February 2006