Liver Biopsy

Liver Biopsy Overview

A liver biopsy is a procedure whereby small pieces of liver tissue are removed in order to be sent to a laboratory for examination. It is very helpful in the diagnosis of diseases that affect the liver.
There are several potential approaches to procuring tissue for a liver biopsy. These are discussed below.
Percutaneous Liver Biopsy
In a percutaneous liver biopsy procedure, local anesthesia is used to numb the skin where a small incision is made. A needle the diameter of a pen refill is then passed through the skin and into the liver, where a specimen is obtained. Multiple biopsies may be taken. In these circumstances, the physician establishes where the liver lies by percussing or tapping on the skin overlying the liver and listening to the sound to find an area of dullness, under which the liver lies. Patient cooperation is critical during the procedure.
Percutaneous Image-Guided Liver Biopsy
A percutaneous image-guided liver biopsyis similar to the one described above except that the needle is guided by CT scan or ultrasound images. This isoften helpful when the disease process is localized to discrete spots in the liver.
Laparoscopic Liver Biopsy
A laparoscopic liver biopsy may be done solely for the purpose of obtaining the biopsy specimen or may be part of another operative procedure. Small incisions are made in the abdomen and instruments are introduced through trocars to obtain the biopsy specimens. The laparoscope is a telescopethat magnifies the objects it sees and allows excellent visualization of the liver surface. Ultrasound can be used as part of this procedure.
Open Surgical Liver Biopsy
Open liver biopsies are rarely performed today unless they are part of another operative procedure. When an open biopsy is done, the surgeon may choose to use a biopsy needle or may surgically excise a small wedge of liver tissue.
There are two main reasons why your doctor may request that you undergo a liver biopsy. (Some of the more common diagnoses for which a liver biopsy is ordered are listed in the next section.)

• Diagnosis: A liver biopsy is a very important and helpful test in the diagnosis of numerous diseases that affect the liver and bile ducts. A small piece or pieces of tissue are removed from your liver and sent for examination. In most cases, this allows establishment of a very specific diagnosis.

• Monitoring: A liver biopsy can help your doctor monitor the effectiveness of therapy that you are receiving for a disease that affects the liver. Likewise, it can provide a warning if certain therapies you are receiving are damaging the liver.