Liver Biopsy

A liver specimen can be obtained during exploratory surgery but is more often obtained by inserting a needle through the skin and into the liver. Before this procedure, called percutaneous liver biopsy, is performed, the person receives a local anesthetic. Ultrasound or CT scans may be used to locate the abnormal area from which the specimen is to be taken. In most medical centers, a liver biopsy is performed as an outpatient procedure.

After the specimen is obtained, the person remains in the outpatient department for 3 to 4 hours because of a small risk of complications, such as laceration of the liver. If the liver is lacerated, bleeding into the abdomen may occur, which can lead to shock. In addition, bile may leak into the abdomen, causing inflammation of the abdominal lining (peritonitis). Because bleeding can start up to 15 days after the biopsy, the person is instructed to stay within an hour's drive of the hospital during that period. These complications can cause serious problems; 1 of 10,000 people die as a result of the procedure. Mild pain in the upper right abdomen, sometimes extending to the right shoulder, is common after a liver biopsy and is usually relieved by analgesics.

In transvenous liver biopsy, a catheter is inserted into a neck vein, threaded through the heart, and placed into one of the hepatic veins that drain the liver. The needle of the catheter is then inserted through the wall of the vein into the liver. This procedure is less likely to injure the liver than is percutaneous liver biopsy. It is especially useful in people who bleed easily, which is a complication of severe liver disease.