Liver Needle Biopsy

Liver Needle Biopsy

It is the process of removing a very small piece from the liver that allows microscopic examination. It allows us to understand the cause and stage of the disease in cases where there is an abnormality in laboratory tests and / or imaging methods. As a result, the treatment of the patient is planned. Sometimes the procedure is done to evaluate the response to treatment.

The most common liver biopsy technique is percutaneous. This is the procedure by inserting a special needle between the ribs. Another liver biopsy method, which is performed especially in patients with bleeding risk, is structured on the neck vein (transjugular). Finally, it is liver biopsy (laparoscopic) performed by incision in the abdomen.

How Is Liver Needle Biopsy Performed?

Before the procedure, sedation is performed through the vascular access to reduce the patient’s concerns about the procedure and increase compliance. The procedure is not performed under general anesthesia and while the patient is asleep. During the procedure, the patient must be conscious and able to control his breathing.

Before starting the procedure, the area where the biopsy will be performed (right upper part of the abdomen, between the ribs) is determined by ultrasonography, if possible. The area where the needle will be made is cleaned with a sterile cloth (with an antimicrobial drug), then a 3-5mm incision is made. A special needle
The procedure is performed with the liver biopsy needle. The process is completed within a few minutes.

Post-Processing Procedure

After the procedure, the patient is laid on his right side for a while, while a hard pillow is placed in the area where the needle was made. Due to possible side effects that may occur in the patient, it is kept for 4 hours after the procedure. After proving that it is completely normal (by abdominal examination), he can be sent home. After the procedure, it is recommended not to drive because of the side effects of anesthetic agents.

Reasons for liver biopsy

  • To solve an undetected liver problem
  • In imaging methods, a pathological condition detected in the liver
  • for illumination
  • To determine the severity of liver disease
  • In order to plan a possible treatment for the liver
  • For the evaluation of a treatment (for the liver) performed
  • To monitor the condition of the liver after a liver transplant
  • In order to evaluate fever of unknown cause

In some cases, it enables both the diagnosis and the stage of the disease:

  • Alcoholic and non-alcoholic fatty liver diseases
  • Chronic hepatitis B and C
  • Autoimmune hepatitis
  • Wilson’s disease
  • Primary biliary cirrhosis (primary biliary cholangitis) and primary sclerosing cholangitis
  • Hemochromatosis

Are there risks to a liver biopsy?

It is a safe procedure when performed by an experienced physician. Especially, performing the procedure with ultrasonography makes the procedure safer. However, possible undesirable consequences of the procedure can be:

  • Pain (the most common side effect, pain relief can be injected, if very severe, more serious complications such as perforation should be considered)
  • Bleeding
  • Infection
  • Rarely, there may be injuries to adjacent organs (such as gall bladder, lung).

If a transjugular liver biopsy is performed, different complications may occur:

    • Bleeding in the neck (hematoma)
    • Temporary problems in facial nerves
    • Temporary sound problems
    • Pneumothorax (needle sticking to the lung)

How to prepare for liver biopsy?

  • Some medications he is taking should be discontinued:
  • Aspirin and other NSAIDs
  • Anticoagulants (such as coumadin)
  • Some herbal products that disrupt the control of bleeding
  • Some tests (blood count prothrombin) to determine the risk of bleeding before the procedure
  • time -PT-, such as INR) should be done.
  • If the platelets are less than 90 000 and the INR is extended more than 3 seconds, the procedure should not be performed
  • There should be 8 hours of fasting before the procedure.

Who cannot have a liver needle biopsy?

  • Those who fear from the procedure and continue to concern about the procedure despite adequate information and sedation
  • Those with bleeding problems
  • Those with tumors that involve the liver blood vessels
  • Those with common acid (fluid in the abdomen)
  • Overweight
  • Those with acute liver infection

Examination of Biopsy

The taken biopsy is sent to the logical pathology (with the addition of clinical information). Pathology clinical information and the clinician’s pre-diagnoses conclude the findings of making special dyes in a report.

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