What is a liver biopsy?

In a liver biopsy, the physician examines a small piece of tissue from your liver for signs of damage or disease. Looking at liver tissue itself is the best way to determine whether the liver is healthy or what is causing it to be damaged.

How is a liver biopsy done?

Prior to starting the liver biopsy test, an IV will be started in order for a sedative to be given during the procedure. You will lay on your back with your right hand placed under your head.  After making the biopsy site on your right side near your rib cage, your physician will inject a local anesthetic to numb the area. Then a small incision is made. You will need to hold very still. The physician will ask you to hold your breath for five to 10 seconds while he or she puts the needle in your liver and immediately withdraws with the specimen. You may feel pressure and a dull pain. The entire liver biopsy test process takes about 20 minutes.

After the biopsy, the physician will put a bandage over the incision and have you lie on your right side, pressing against a towel for one to two hours. The nurse will monitor your vital signs and level of pain.  You will be in the recovery room at least 4 hours. You will need to arrange for someone to take you home since you will not be allowed to drive after having the sedative. You must go directly home and remain in bed (except to use the bathroom) for eight to 12 hours, depending on your physician's instructions. Avoid exertion for the next week so that the incision and liver can heal. You can expect a little soreness at the incision site and possibly some pain in your right shoulder. This pain is caused by irritation of the diaphragm muscle (the pain usually radiates to the shoulder) and should disappear within a few hours or days.  Your physician may recommend that you take Tylenol for pain, but you must not take aspirin or ibuprofen for the first week after the liver biopsy procedure. These medications decrease blood clotting, which is crucial for healing.

Preparation for a liver biopsy

If you use aspirin, NSAIDS (such as Ibuprofen), coumadin and/or Plavix, notify your physician as soon as possible.  If you take any diabetes medicine you need to talk with your physician prior to the liver biopsy procedure. Before the procedure, your physician will take blood samples to make sure your blood clots properly.  You must not eat or drink anything for eight hours before the biopsy. If you receive sedation for your procedure, you will need to have someone drive you home.