Check-up liver biopsy

The Irish Times - Tuesday, January 25, 2011
MARION KERR

I’m booked in for a liver biopsy and wonder what the procedure will involve?

A liver biopsy is used to help diagnose many liver diseases. The procedure can help assess the stage of liver disease in conditions such as hepatitis C infection. It may also detect cancer, infections and the cause of abnormal levels of liver enzymes found in blood tests.

A liver biopsy takes a sample of tissue from the liver for laboratory examination. It may be performed either as a day-case procedure or during a hospital admission.

A sedative medication or pain medication is usually given by injection before the test. If the biopsy is done through the abdominal wall, you will be lying on your back with your right hand under your head. You will be asked to lie as still as possible throughout the test.

Ultrasound is used to guide the biopsy needle. The skin is cleansed, and local anaesthetic injected to numb the area. A small cut is made in the skin.

The biopsy needle is inserted, usually guided by ultrasound. You will be instructed to hold your breath while the biopsy is taken. This is to reduce the chance of puncturing the lung or tearing the liver.

Once the biopsy needle is removed, pressure will be applied to stop the bleeding and a bandage placed over the insertion site.

My doctor said something about having the test done through a vein in my neck.

Liver biopsy can also be performed by inserting a needle into the jugular vein in the neck. Again, you will lie on your back on a table and the internal jugular vein will be located. The skin will be cleansed and local anaesthetic will be injected to numb the area. A needle is then inserted to pass a catheter through the veins to the liver. X-ray equipment will be used to check the location of the catheter.

A specialised needle is then used through the catheter to take the biopsy sample. In both types of biopsy, you may feel a mild stinging sensation from the anaesthetic needle and when the anaesthetic is injected. The biopsy needle may feel like deep pressure and dull pain. Some people experience pain in the shoulder.

Risks may include a collapsed lung, complications from the sedation, accidental injury to the gallbladder or kidney and internal bleeding.

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