Liver Biopsy as Inpatient

Inpatient Liver Biopsy Information

During this procedure a small piece of liver tissue is removed from the liver and is then sent to be analysed under a microscope. This is often the best way to investigate liver problems.

A liver biopsy is performed using a needle inserted through the skin between the lower ribs on the right hand side of the body. Local anaesthetic is injected into the skin and muscles lying over the liver. The anaesthetic stings for a few seconds before the area goes numb. It is possible to be sedated before the procedure if you are particularly anxious, but this is very rarely necessary. You will be asked to hold your breath for a few seconds during which time the needle is inserted into the liver and removed. Sometimes it is necessary to repeat the procedure once or twice more in order to obtain enough liver tissue for analysis.

Before the Procedure

You will have received confirmation of the date of admission for liver biopsy from your consultant’s medical secretary. This will be accompanied by 2 blood test request forms. You must get these blood tests done in the 7 days before your date of admission, preferably the day before admission. You may be able to make an appointment for this with the practice nurse at your GP surgery. Alternatively, you could come to the hospital outpatient department between 9am-5pm on weekdays without an appointment. On the day of admission, you may have a light breakfast before 7am, but nothing to eat after this until after the liver biopsy has been done.

After the Procedure

After the biopsy you will be asked to lie in bed for 6 hours. During this time the nurse will be measuring your pulse and blood pressure at frequent intervals. After this you will be kept under observation overnight, but you will not be confined to the bed. If there have been no complications, you will be discharged home the morning after your biopsy.

The results of the biopsy take at least 3 weeks to be processed and reported. Your consultant will then either write to you with the result or arrange an outpatient appointment to discuss the results in detail.

What are the Risks and Complications?

In the vast majority of patients liver biopsy is a simple and safe procedure, although rarely complications may occur.

• As the liver contains many blood vessels, the main risk is bleeding. Usually this simply results in a bruise around the liver but occasionally (1 in 250 cases) there can be more serious bleeding needing a blood transfusion. Very rarely an operation is required.
• Bleeding into the bile ducts draining the liver occurs in 1 in 2000 cases.
• 30% of patients complain of some pain after a liver biopsy and you will be offered a pain relief tablet to relieve this.
• Moderate pain occurs in 3% and severe pain in 1.5% of biopsies.
• Extremely rarely (1 in 1000 – 1 in 10 000 procedures), the liver is missed and tissue from another adjacent organ is taken, for example lung, intestine, kidney or gall bladder. Fortunately this does not usually cause any serious problems.
• The risk of death after liver biopsy is extremely low, 1 – 4 in 10 000 cases.