Liver Biopsy

A liver biopsy is a short procedure to remove a small piece of liver tissue. It can then be examined under a microscope and tested chemically in the laboratories. A percutaneous liver biopsy is carried out by inserting a needle through the skin (percutaneously). The liver is the largest organ in the body and is located in the top right hand side of the abdomen.

A liver biopsy is a procedure in which a small needle is inserted into the liver to collect a tissue sample. This is performed as an office or outpatient procedure or during surgery. The tissue is then analyzed in a laboratory to help doctors diagnose a variety of disorders and diseases in the liver.

Why does child need this procedure?

A liver biopsy is usually suggested when a child has an abnormally large liver or abnormal blood results, which indicate that the liver is not working properly. The doctors can tell a certain amount by examining your child’s blood, but there are some diseases that can only be diagnosed by a liver biopsy – for example some metabolic disorders. The reason for your child’s biopsy will be discussed with you fully by your child’s doctors.

What happens before the biopsy?

If your child is taking certain medicines on a regular basis, these will need to be stopped a few days before the liver biopsy is due to take place. Ibuprofen and other non-steroidal anti-inflammatory drugs (NSAIDs) need to be stopped three days beforehand.

Your child will need to come into hospital the day before the procedure and should be able to go home the day after the procedure, unless he or she needs any further investigations or treatment.

Your child’s doctor will see you when you arrive at the hospital to explain the procedure in more detail, discuss any questions you may have and ask you to sign a consent form. Your child will need to have a mild general anaesthesia or sedation. This means that your child will not be able to have any food or milk for six hours before the procedure, although he or she can have clear fluids up to three hours beforehand.infants are started with intravenous fluids to prevent hypoglycaemia.
Your child will need a test to check his or her blood clotting the day before the biopsy like PT/APTT/INR For this your child will have a small plastic tube (a cannula) inserted into a vein.

What does the biopsy involve?

The doctor will use an ultrasound scan to find the best place from which to take the biopsy. When this has been locatated, a local anaesthetic injection will be used to numb the area, before the needle is inserted through the skin into the liver. The needle will then be removed containing a small ‘plug’ of liver tissue. This will then be sent to the laboratories for detailed examination.

The incision site will be closed by appropriate dressing. There might be some bleeding straight after the procedure, but this will stop when pressure is applied to the site. The biopsy itself only takes a few minutes.

Are there any risks involved?

Every anaesthetic carries a risk of complications, but this is very small. Sometimes after a general anaesthetic, a child may feel sick and could actually vomit. Your child may also complain of a headache, sore throat and feeling dizzy and may be upset. These side effects are usually short lived.

Liver biopsy carries some specific risks; pain is the most common side effect of liver biopsies. There is also a small risk of bleeding. If this occurs, it usually starts within a few hours of the biopsy.

What happens after the biopsy?

Your child will be able to recover from the biopsy on the ward and may be sleepy for a few hours as the anaesthetic wears off. Your child’s blood pressure, pulse and breathing rate will be monitored every 15 minutes initially, then less frequently as your child recovers. The local anaesthetic given during the procedure will start to wear off a few hours after the biopsy, but we will give your child pain medicines to keep the area comfortable.

Your child should remain in bed for 24 hours after the biopsy and ideally, he or she should lie on the right hand side as much as possible.

The results of the biopsy are usually available within a 3 days, but more complicated tests can take longer. All the biopsy results will be given to you at your child’s next outpatient appointment, but if there is a need to change your child’s treatment before this time, you will be contacted directly.