Tuesday, April 14, 2020

What is Liver Biopsy

Liver biopsy is a procedure in which a tissue sample is taken from the liver with the help of a needle. Then it is sent to the lab for evaluation which helps the doctor in diagnosing many diseases and liver diseases.

The most common method of percutaneous liver biopsy is by inserting a small needle through the abdomen to remove a small piece of tissue from the liver. There are also two other methods of liver biopsy - one uses a neck vein while the other involves making a small incision  in the abdomen to remove the liver tissue from a needle.





Why is Liver Biopsy done?



Liver biopsy is done to identify signs of damage and disease. It also determines the severity of liver disease.

The doctor will recommend a liver biopsy if you:

Liver test results are abnormal which cannot be explained
Imaging test showing multiple tumors or abnormalities in liver
Frequent fever, lack of clarity
Liver biopsy is usually performed to diagnose and stage certain liver diseases, including:

  • Non Alcoholic Fatty Liver Disease
  • Chronic hepatitis b or c
  • Autoimmune hepatitis
  • Alcoholic liver disease
  • Primary biliary cirrhosis
  • primary sclerosing cholangitis
  • Hemochromatosis
  • Wilson Disease f




Precaution / Warning





What should I know before liver biopsy?



Liver biopsy is not for everyone. It is not recommended if:

The patient is unable to remain calm during the long duration of the procedure.
Suspected Vascular List
Bleeding tendency (eg, INR> 1.2 despite receiving vitamin K, bleeding time> 10 minutes)
Severe thrombocytopenia (<50,000 / mL)
You will feel some pain and uncomfortable feeling at the place of biopsy. There may also be pain in your shoulders and back. You will be given a pen killer if necessary.

Liver biopsy by an experienced doctor is absolutely safe. Possible risks:

It is normal to feel pain and discomfort at the place after the biopsy. If you have more pain, you may be given pain medications, such as acetaminophencodine (with tylenol) with codeine.

Bleeding also occurs after liver biopsy. In case of excessive bleeding, blood transfusion or surgery may be required to prevent it.





Rarely, bacteria can enter the abdominal cavity or bloodstream.

Occasionally accidental injury may occur during liver biopsy. The needle may stick to an internal organ such as the sacrum or lungs.

In the transjugular process a thin tube is inserted into the large vein of the neck that passes through the liver. Risks associated with transjugular liver biopsy:

Collection of blood in the neck (hematoma). Blood may pool around the site where the catheter was inserted, possibly causing pain and swelling.


Temporary problem of facial veins. The transjugular process can sometimes cause damage to the nerves of the face or eyes, which can cause problems such as drooping eyelids for some time.
There may be a voice-related problem for some time. The voice may decrease or go away for a while.
The lungs may be punctured. If the needle accidentally sticks to the lungs it can be damaged.


process


How to prepare for Liver Biopsy?


While preparing for a liver biopsy, you should:

The doctor will have to tell you about your pregnancy, lame or heart condition, if you are allergic to any medicine or have bleeding problems.
Tell the doctor if you are taking any medicines to thin the blood. Before the procedure the doctor will tell you any other alternative.
Talk to the doctor about the procedure.
If any necessary blood test has been done, tell.
Find out how many hours before the procedure you have to eat nothing.
Make arrangements to go home after the procedure.
Do not take aspirin a few weeks before the procedure, do not take aspirin products or anti-inflammatory drugs (such as ibuprofen, Advil, Motrin, Naprosyn, etc.) unless doctors recommend it. Do not stop any medicine already taken without doctor's advice.

Lab tests can be done on the day or 2-3 days before liver biopsy, as the doctor says. These tests test blood count, platelet count and blood clotting ability.



What happens during liver biopsy?


This process takes just 5 minutes. You can be kept in a 4-hour recovery room for observation.

This test can be done at a hospital or other health center. For this you have to come early in the morning. The health team will examine your medical history and the medications you take.

Before the biopsy you should:

An IV line will be placed in the arm vein so that medication can be given if needed.
Sedatives can be given to enable you to relax during the procedure.
Use the toilet if needed, as you will have to stay in bed for a few hours after the procedure.
The stages of liver biopsy may differ depending on the methods adopted for:

Percutaneous biopsy. To begin your biopsy, the doctor will detect the liver by tabbing on the abdomen or through an ultrasound picture. In some cases, ultrasound is used to deliver the needle to the liver during a biopsy. You will lie on your back and place your right hand on the table above the head. Where the needle is injected, the doctor will apply the medicine to numb this part. The doctor then makes a small incision under the rib cage on your right side and inserts a biopsy needle. The biopsy takes just a few seconds. When the needle comes out inside the liver, then you are asked to hold your breath.

Transjugular biopsy. You will take the back of the X-ray table. Your doctor will apply numbing medication on one side of your neck, then make a small incision and insert a flexible plastic tube into the jugular vein. The tube is threaded into the jugular vein and the largest vein (hepatic vein) of the liver. The doctor then injects contrast dye into the tube and produces the series of X-ray images. Dye looks at the pictures, showing the doctor a hepatic vein. The biopsy needle is then inserted into the tube and one or more cells are removed from the liver for sampling. The catheter is carefully removed and a bandage is placed where the incision is made on the throat.


Laparoscopic biopsy. You are given general anesthetics during a laparoscopic biopsy. On the table you will have to lie on your back, the doctor will make one or more small incisions in your abdomen. Through this special tools are inserted inside, including a small video camera with the help of which the inside photo is seen in the operating room. With the help of these photos, the doctor instructs special tools to remove the liver tissue. Then the tools are removed and the stitches are placed on the incision.



What happens after liver biopsy?




After a biopsy you can expect:


You will be taken to the recovery room, where the nurse will check your blood pressure, plus and breath.
Rest for 2 to 4 hours If a biopsy is done by a transjugular procedure, more rest is needed.
After a few weeks you can start your routine life.
Consult your doctor if you have any kind of question about liver biopsy and understand it better.



Understand the consequences



What do my results mean?


The specialist doctor (pathologist) in the lab will examine your liver tissue. Through it, he detects liver disease or any kind of damage. The result of biopsy comes within a few days to a week.

The doctor will explain it to you after the results. Your liver disease is diagnosed or graded based on its severity - very few, normal or severe. If you need some kind of treatment, the doctor will talk to you about it.

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