Download Page 1 of 4 Ultra sound guided liver biopsy performed in the

Ultra sound guided liver biopsy performed in the Radiology Department
What is a Liver Biopsy?
A liver biopsy is a procedure for obtaining a small piece of liver tissue. Your liver biopsy
sample will be examined under a microscope and a report is produced for your consultant.
This usually takes about two weeks, but it could be longer depending upon the findings.
A liver biopsy is considered to be a routine procedure by most specialists, but for a patient
about to experience a liver biopsy it can be an anxious and worrying time. This information
sheet will help to explain the procedure and answer any concerns you may have, but
discussion with your doctors prior to the liver biopsy is also important.
The biopsy is usually performed as a day case and only occasionally does it require an
overnight stay. You should bring an overnight bag just in case you do need to be kept in
hospital. If you live more than 30 minutes away from the hospital it is recommended that you
remain in hospital overnight.
Why am I having a liver biopsy?
Your consultant has recommended that you have a liver biopsy to help assess and diagnose
the problem in your liver. There are many causes of liver disease and it is sometimes difficult
to diagnose a condition based on symptoms and simple blood tests such as Liver Function
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Tests (“LFTs”). Often the only way to diagnose a liver disease and identify how advanced it
is, is to perform a liver biopsy.
Is there any preparation for the procedure?
Firstly blood samples will be taken to check it is safe to go ahead with the procedure with
minimal risks. If the biopsy is being performed as a day-case procedure then you will be
asked to attend the Radiology department for a pre-assessment a day or two before the
procedure where these blood tests will be taken. Only if the results are satisfactory will the
biopsy proceed. If you are already a patient in the hospital the ward staff will arrange for
these blood samples to be taken.
You will need to give your consent for this procedure, you will have the opportunity to discuss
the liver biopsy with your consultant prior to the biopsy – take the opportunity to ask any
questions. If you have any special needs please feel free to discuss these with us.
Will I still take my normal medication?
You will be asked not to take medications that affect blood clotting such as Aspirin,
Clopidrogel & Warfarin for a number of days prior to the biopsy. You will need to discuss your
medication with your doctor. This will also be discussed at your pre assessment appointment.
What will happen when the biopsy is being performed?
You will be brought to the x-ray department on a trolley, and the procedure will be performed
whilst you are lying on this trolley.
Your liver is located in the right uppermost part of your abdomen. It also lies under the lower
part of your ribcage. The biopsy is obtained by passing a small needle through the skin into
the liver. This may be above the site of the liver (on the right side of your abdomen and
below your ribs) or more likely between your lower ribs on your right side. The radiologist (xray doctor) performing the biopsy will use an ultrasound machine to locate the area of the
liver that they want to take the biopsy from and they will place a mark on your skin to identify
it. Depending on where this is you will be asked to lie still in the same position. This may be
on your left side or on your back. The skin over the liver is cleaned with antiseptic and sterile
drapes will cover the surrounding area. Local anaesthetic is then injected into a small area of
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skin & tissue at the site the radiologist has marked. This stings at first, but then makes the
area numb.
Once the anaesthetic has had time to work a special hollow needle is pushed though 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 be asked to gently hold your breath for a few seconds. The doctor will tell you exactly
when this is because the liver moves slightly when you breathe in & out. As the needle
comes out it brings with it a small sample of liver tissue.
The radiologist will cover the area with a small dressing.
The procedure takes approximately 30 minutes from start to finish.
After the liver biopsy.
After the procedure you will return to the ward where the nurses will check your wound and
your blood pressure and pulse regularly for the next four hours. You will need to stay in bed
for this length of time and may be asked to lie on your right side for a while. This is to help
the wound stop bleeding as the weight of your body is on the wound. Some patients
experience shoulder tip pain following the procedure. The nurses will be able to give you pain
killers if this occurs.
You may eat & drink normally.
What are the risks of a liver biopsy?
As with all medical procedures, there are risks involved. The vast majority of patients have
no significant problems.
Minor Risks
Pain is the commonest complication occurring in up to a third of patients. This is usually mild
and responds to mild pain killing tablets. Moderate and severe pain occurs in less than 3 in
100 patients and can be treated with stronger painkillers.
In a small number of cases there is some bleeding from the biopsy site .This is usually minor
& soon stops
Major Risks
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There is a small risk of either bleeding internally or bile leaking internally from the liver, but
this is uncommon and not seen in the vast majority of patients. Severe complications occur
in less than 1 in 500 patients. Occasionally the bleeding is more severe and rarely it requires
a blood transfusion and, or an operation to deal with it.
You should discuss risks and complications with your consultant and the doctor performing
the biopsy.
Are there any alternative procedures?
There are no alternative procedures to the liver biopsy. You do of course have the choice to
not have the biopsy, although you should discuss this carefully with your doctor.
When will I get the results?
The result of the biopsy may take about two weeks to come back. For this reason you will not
get your results when you have the biopsy taken. The results will be sent to the consultant
who asked for you to have the liver biopsy and they will contact you with the results.
If you have any queries about your biopsy please contact:
The X-ray department pre assessment nurse on 0191 445 3260 or the X-ray Sister on 0191
445 2925 Monday to Friday 9am to 5pm.
If you need to advise following your liver biopsy outside the above hours please contact your
General Practitioner.
Reference: British Society of Gastroenterologists Guidelines in Gastroenterology. October
2004.
Information Leaflet:
Version:
Title:
First Published:
Last Reviewed:
Review Date:
Author:
NoIL61
3
Ultrasound Guided Liver Biopsy
February 2007
January 2013
January 2015
Maggie Williams, Clinical Lead Nurse, Radiology
This leaflet can be made available in other languages and
formats upon request
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