Liver biopsy

A liver biopsy is a procedure to remove a small piece of liver tissue, so it can be examined in a lab under a microscope for signs of damage or disease. Your healthcare professional may recommend a liver biopsy if blood tests or imaging studies suggest you might have a liver problem. A liver biopsy also is used to find out the state of someone's liver disease. This information helps guide treatment decisions.

A liver biopsy may be done to: Look for the cause of a liver problem that can't be found with a healthcare professional's exam, blood tests or imaging studies. Get a sample of tissue from an irregularity found by an imaging study. Find out how bad liver disease is, a process called staging. Help create treatment plans based on the liver's condition. Find out how well treatment for liver disease is working. Check on the liver after a liver transplant. Your healthcare professional may recommend a liver biopsy if you have: Irregular liver test results that can't be explained. A tumor or other irregularities on your liver as seen on imaging tests. A liver biopsy also is most often done to help diagnose and stage certain liver diseases, including: Nonalcoholic fatty liver disease. Chronic hepatitis B or C. Autoimmune hepatitis. Liver cirrhosis. Primary biliary cholangitis. Primary sclerosing cholangitis. Hemochromatosis. Wilson's disease.

A liver biopsy is a safe procedure when done by an experienced healthcare professional. Possible risks include: Pain. Pain at the biopsy site is the most common complication after a liver biopsy. Pain after a liver biopsy is usually mild. You may be given pain medicine, such as acetaminophen (Tylenol, others), to help manage the pain. Sometimes a narcotic pain medicine, such as acetaminophen with codeine, may be prescribed. Bleeding. Bleeding can happen after a liver biopsy but is not common. If there is too much bleeding, you may need to be hospitalized for a blood transfusion or surgery to stop the bleeding. Infection. Rarely, bacteria may enter the stomach cavity or blood. Accidental injury to a nearby organ. In rare instances, the needle may stick another internal organ, such as the gallbladder or a lung, during a liver biopsy. In a transjugular procedure, a thin tube is inserted through a large vein in the neck and passed down into the vein that runs through the liver. If you have a transjugular liver biopsy, other rare risks include: Collection of blood in the neck. Blood may pool around the site where the tube was inserted, possibly causing pain and swelling. The collection of blood is called a hematoma. Short-term problems with the facial nerves. Rarely, the transjugular procedure can injure nerves and affect the face and eyes, causing short-term problems, such as a drooping eyelid. Short-term voice problems. You may be hoarse, have a weak voice or lose your voice for a short time. Puncture of the lung. If the needle accidentally sticks your lung, the result may be a collapsed lung, called pneumothorax.

Before your liver biopsy, you'll meet with your healthcare professional to talk about what to expect during the biopsy. This is a good time to ask questions about the procedure and make sure you understand the risks and advantages.

What you can expect during your liver biopsy will depend on the type of procedure you have. A percutaneous liver biopsy is the most common type of liver biopsy, but it isn't a choice for everyone. Your healthcare professional may recommend a different type of liver biopsy if you: Could have trouble holding still during the procedure. Have a history of or are likely to have bleeding problems or a blood-clotting illness. Might have a tumor involving blood vessels in your liver. Have a lot of fluid in your stomach, called ascites. Are very obese. Have a liver infection.