Did the doctor tell you to have a liver biopsy? Let's talk about this simply (Liver Biopsy)

When the doctor told you that you needed to have a liver biopsy, you were a little scared and nervous, right? "Why is that?", "Will it hurt a lot?", "Is it a big operation?" Many questions must have come to mind. Don't be afraid, this is not as big or scary as you often think. Let's talk about this in detail and simply today.

Simply put, what is a liver biopsy?

A liver biopsy is a minor medical procedure in which a very small piece of tissue (tissue sample) is taken from your liver using a special needle. Just like we take a blood sample for a test to diagnose a disease, in this case, a small piece of the liver itself is taken and examined.

The tissue sample is sent to the lab, where a pathologist , a doctor who specializes in examining tissue and diagnosing diseases, looks at it under a microscope to determine exactly what kind of liver disease it is.

Why do we need to do a Liver Biopsy?

There are two main reasons for this.

1. Diagnosis: Sometimes your scan or blood tests may suggest that there is a problem with your liver. But it may not be 100% certain what it is. In such cases, doctors say that this biopsy test is the best way to confirm some liver diseases (gold standard).

2. Staging: If you have chronic liver disease, this test is also used to determine how far it has spread and how much damage has been done to the liver. In particular, it can give a score (F0 to F4) of the degree of fibrosis , that is, the formation of scar tissue that does not heal. This is how the medication, treatment, and prognosis are determined.

What diseases can be identified with this test?

A liver biopsy can diagnose a variety of liver-related conditions.

How is a Liver Biopsy performed? What are the methods?

There are three main ways to do this. Your doctor will choose the most appropriate method based on your situation.

1. Percutaneous Liver Biopsy

This is the most commonly used and simplest method. 'Percutaneous' means 'through the skin.' The doctor takes the sample by inserting a small needle through the skin on the right side of your abdomen, under your ribs, directly into the liver.

2. Transvenous Liver Biopsy

This method is used if you are at risk of bleeding, or if you have a condition such as ascites. 'Transvenous' means 'through a vein'. Here, a small tube (catheter) is inserted through a large vein in the neck (the jugular vein), and the needle is passed through that tube to the liver.

3. Surgical Liver Biopsy

Sometimes, a piece of the liver can be removed during abdominal surgery (open or laparoscopic surgery) for another reason.

How to prepare before a biopsy?

There are a few things you need to do before this.

• Talking to your doctor: Talk to your doctor about your health history and the medications you are taking. Some medications, such as blood thinners, may be asked to be stopped about a week in advance.
• Blood tests: A blood test will be done to check your blood clotting ability. If there is a deficiency, it can be treated before the biopsy.
• Fasting: You are usually asked to refrain from eating or drinking for about 8 hours before the test. However, follow your doctor's instructions exactly.
• Plan ahead: If you are going to be given sedation, arrange for someone to drive you home in advance. Also, be prepared for the week of rest after the biopsy.

What happens on the day of the biopsy?

The test takes about 15-30 minutes, but you will have to stay in the hospital for several hours under observation afterwards.

While taking the test:

1. You will be made to lie down on a bed, and the area where the needle will be inserted (right side of the abdomen or neck) will be thoroughly cleaned and an antiseptic applied.

2. Next , a local anesthetic is injected into the area. You will feel a slight burning sensation when this is applied, but the area will numb within about a minute.

3. After the area is numb, the doctor makes a small incision and inserts the biopsy needle through it.

4. You may be asked to hold your breath for a while. There is no pain when the needle goes in, but you may feel a slight pressure inside .

5. After a few seconds, the sample is taken and the needle is removed. Then a plaster is applied to the area.

6. After the biopsy, you will be turned onto your right side for a while. This will help to put pressure on the liver with your own weight and help stop the bleeding.

Are there any risks after the test?

This is generally a very safe test. Serious complications are rare (about 0.1%). However, a few minor complications can occur.

• Pain: You may experience some mild pain in the right side of your abdomen or right shoulder after the test. This can usually be controlled with painkillers.
• Low blood pressure: Some people may feel a little dizzy. This usually goes away after a while.

However, if you experience the following symptoms after returning home, you should call your doctor immediately .

• High fever
• Severe weakness or fainting
• Difficulty breathing
• Heart palpitations
• Yellowing of the eyes or skin (Jaundice)
• Severe pain
• Abdominal bloating

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