LIVER BIOPSY
Liver Biopsy
A liver biopsy is a procedure to remove a small piece of liver tissue with the help of a small needle, so it can be examined under a microscope for signs of damage or disease. It can be used to diagnose various liver diseases, to assess severity of liver damage and to diagnose liver cancer.
Our area of clinical expertise include:
Indications
❖ Persistently abnormal liver blood tests
❖ Unexplained jaundice
❖ liver abnormality found on imaging (USG, CT scan)
❖ Unexplained enlargement of liver
❖ To estimate the degree of liver damage, to grade and stage hepatitis B and C
❖ Sometimes, before stopping the treatment in case of autoimmune hepatitis
❖ To diagnose liver tumors when imaging and blood reports fail to give conclusive diagnosis
Types: Percutaneous:
This is the most common type of liver biopsy. In this, a small needle is passed through the skin after numbing the skin with local anesthetic agent injection. Under sonographic guidance, the position of the biopsy needle is confirmed and then a small piece of liver tissue is removed. It is sent to the laboratory in a special solution (formalin) for further diagnosis.
The patient can take light breakfast on the morning of the procedure. It is usually a day-care procedure and patient can go home after 4 hours of observation and can resume routine activities from next day. Some high risk patients may need transfusion of some blood products before the procedure and overnight admission after it.
It is usually a safe procedure. Some pain and bruising at the puncture site is common. Infection at the biopsy site or injury to some other organs are less common complications. Life threatening complications are rare (1 in 10,000).
EUS guided:
Endosonography can be used for evaluation of liver, biliary tract, portal vein, hepatic veins and at the same time if no other cause of liver abnormality is found, liver biopsy can be taken with the help of a special EUS needle. The patient needs to come prepared as instructed (See EUS for further information).
Trans-jugular:
In this procedure, the needle is passed through the vein in the neck to reach the liver and biopsy is taken. It is usually performed in patients with advanced liver disease in whom the blood is excessively thin, liver is very hard or there is plenty of fluid (ascites) around liver, making them more vulnerable for life threatening bleeding complications.
Laparoscopic:
It’s a surgical procedure requiring general anesthesia and skin incision. Usually, laparoscopy is done for some other diagnostic or therapeutic purpose and simultaneously liver biopsy can be taken. Use of laparoscopy only for liver biopsy is not advisable in view of presence of other less invasive methods.
DEPT OF MEDICAL GASTROENTEROLOGY
DR. K. K. RAWAL (MD, DM – GASTRO)
DR. AVVAL K. SADIKOT (MD, DNB-GASTRO)
DR. CHINTAN H. KANSAGRA (MD,DNB – GASTRO)
DR. CHINTAN M. MORI (MD,DNB – GASTRO)
