A biopsy of the liver is a medical procedure in which a small amount of liver tissue is surgically removed so it can be analyzed in the laboratory by a pathologist.
Liver biopsies are usually done to detect the presence of abnormal cells in the liver, like cancer cells, or to evaluate disease processes such as cirrhosis. Your doctor may order this test if blood or imaging tests indicate there are problems with your liver.
The liver is a vital organ. It produces proteins and enzymes responsible for essential metabolic processes, removes contaminants from your blood, helps fight infection, and stores essential vitamins and nutrients. Problems with your liver can make you very sick or lead to death.
Your doctor may order a biopsy to help determine if an area is infected, inflamed, or cancerous. Symptoms that a doctor would test for include:
- digestive system issues
- persistent abdominal pain
- right upper quadrant abdominal mass
- laboratory tests pointing to the liver as an area of concern
A liver biopsy is usually done if you received abnormal results from other liver tests, have a tumor or mass on your liver, or suffer from consistent, unexplainable fevers.
While imaging tests like CT scans and X-rays can help identify areas of concern, they can’t differentiate between cancerous and noncancerous cells. For this, you need a biopsy.
Although biopsies are typically associated with cancer, it doesn’t mean you have cancer if your doctor orders this test. Biopsies also allow doctors to see if a condition other than cancer is causing your symptoms.
A liver biopsy can be used to diagnose or monitor a number of liver disorders. Some conditions that affect the liver and may require a biopsy include:
- alcoholic liver disease
- autoimmune hepatitis
- chronic hepatitis (B or C)
- hemochromatosis (too much iron in the blood)
- nonalcoholic fatty liver disease (FLD)
- primary biliary cirrhosis (which leads to scarring on the liver)
- primary sclerosing cholangitis (which affects the liver’s bile ducts)
- Wilson’s disease (an inherited and degenerative liver disease caused by excess copper in the body)
Any medical procedure that involves breaking the skin carries the risk of infection and bleeding. The incision for a liver biopsy is small and needle biopsies are less invasive, so the risk is much lower.
Biopsies don’t require much preparation on the part of the patient. Depending on your condition, your doctor may ask you to:
- undergo a physical examination and complete medical history
- stop taking any medications that affect bleeding, including pain relievers, anticoagulants, and certain supplements
- have your blood drawn for a blood test
- not drink or eat for up to eight hours before the procedure
- arrange for someone to drive you home
Just before the procedure, you’ll change into a hospital gown. Your doctor will give you a sedative through an intravenous (IV) line to help you relax.
There are three basic types of liver biopsies.
- Percutaneous: Also called a needle biopsy, this biopsy involves putting a thin needle through the abdomen and into the liver. The Mayo Clinic states that it’s the most common type of liver biopsy.
- Transjugular: This procedure involves making a small incision at the neck. A thin flexible tube is inserted through the neck’s jugular vein and into the liver. This method is used for people who have bleeding disorders.
- Laparoscopic: This technique uses tube-like instruments that collect the sample through a small incision in the abdomen.
The kind of anesthesia your doctor gives you will depend on which type of liver biopsy they perform. The percutaneous and transjugular biopsies use local anesthesia, meaning that only the affected area is numbed. Laparoscopic biopsies require general anesthesia, so you’ll be in a deep, painless sleep during the procedure.
When your biopsy is complete, any incision wounds will be closed with stitches and properly bandaged. You will typically have to lie in bed for a few hours after the procedure while doctors monitor your vital signs.
Once you receive approval from your doctor, you are free to go home. You should take it easy and rest for the next 24 hours. However, you should be able to get back to your normal life after a few days.
After the tissue sample is taken, it will be sent to a laboratory for testing. This could take up to a few weeks.
When the results are back, your doctor will call you or ask you in for a follow-up appointment to share the results. Once a diagnosis is reached, your doctor will discuss any recommend treatment plans or next steps with you.