Liver Biopsy - Percutaneous
This is a general description of what you can expect during a percutaneous (through the skin) liver biopsy. Your doctor or other medical staff will give you special instructions that you must follow carefully. Depending on the reason for your biopsy, the procedure, preparations, and aftercare may differ slightly from person to person.

What It Is
A liver biopsy is a diagnostic procedure that involves the removal of a very small sample of liver tissue. During a percutaneous liver biopsy, a tissue sample is taken by inserting a slender, hollow needle between the ribs on your right side. The sample is then analyzed in a laboratory to confirm a diagnosis, to determine the extent of liver damage from diseases such as cirrhosis or hepatitis, or it may be used to confirm the presence of a tumor. A biopsy is also performed after a liver transplant to determine whether rejection of the new liver is taking place.

What To Expect:
The biopsy is most often performed in the outpatient center of a hospital. The actual procedure takes only a few seconds, but preparation and examinations may require a half-hour or more. You will also be expected to rest quietly in bed for several hours afterwards. Practices vary depending on the reason for the liver biopsy. In some cases, an ultrasound or CT scan machine is used to determine the best location for the biopsy, but a visual exam is often sufficient. Your pulse, temperature, and blood pressure will be taken, and you may also have blood tests or other examinations that day. The blood pressure cuff will remain on your arm to monitor your blood pressure during the procedure. In addition, a nurse may insert a needle intravenously in your arm and secure it there. It might not deliver an intravenous solution during the procedure, but having the needle in place is a precautionary measure in the unlikely event of emergency.

You will be given a surgical gown to wear, and you will be asked to undress, although you may be allowed to keep your underwear or pants on. A mild sedative may be offered, but general anesthesia is not given because you must hold your breath for a few moments when the needle is inserted. You will be asked to raise your right arm over your head and perhaps turn to the left slightly. The doctor will carefully examine the right ribcage area and clean it with an antiseptic solution. He or she may also make a mark where the needle is to be placed. The doctor will inject the area with a local anesthetic. This will numb the area so you don’t feel any pain. When everything is ready, you will be asked to hold your breath and remain motionless (this is extremely important). Your doctor will then insert the needle and withdraw the tissue sample very quickly. This takes only a few seconds, and as soon as the needle is withdrawn, you can resume regular breathing. A bandage will be placed over the site, and you will be asked to lie on your side and rest.

Afterwards
Many patients say they don’t feel any pain during or after the procedure, although the needle that injects the local anesthetic may sting or make a sharp pain for a brief moment. Some patients experience temporary discomfort in the chest or shoulder area later on, and your doctor may prescribe a mild pain reliever for you. You will be asked to relax for the remainder of the day, but in most cases, you can return to work the following day. Complications with a percutaneous liver biopsy are uncommon. When they do occur, they usually involve excessive bleeding and are remedied easily without need for further surgery. In most cases, a small, red mark at the needle insertion site may be visible for a few weeks, but it fades rapidly, and there will be little if any discernible scarring.

Summary
This type of liver biopsy is a simple, relatively painless diagnostic procedure that is very useful and often necessary to ensure the best healthcare possible. If your doctor has recommended a liver biopsy for you, be sure to pay close attention to his or her special instructions, get them in writing, and follow them. Ask questions and get clarifications if necessary, and request additional literature about your condition and your biopsy. The best way to feel comfortable and relaxed about a medical procedure such as a liver biopsy is to know what to expect.