Our Summary

This research paper discusses the role of liver biopsy in diagnosing liver diseases. While imaging and blood tests have become popular diagnostic tools, they are not always conclusive. Therefore, analyzing liver tissue often remains the best way to make a diagnosis. Various factors can affect the quality of a biopsy: the number and size of samples taken, the needle size, number of attempts, the use of imaging guidance, and the skill of the person performing the biopsy. The study found that liver biopsies were particularly useful for identifying the cause of persistently abnormal liver tests, providing a specific diagnosis in 84% of cases. There are concerns about the risk of bleeding during liver biopsies, particularly for patients with clotting abnormalities. However, the study found that using less stringent thresholds for clotting before the procedure did not increase the risk of bleeding. The paper concludes that looking at liver tissue under a microscope is still a vital tool for diagnosing liver diseases and determining their severity.

FAQs

  1. What role does a liver biopsy play in diagnosing liver diseases?
  2. What factors can affect the quality of a liver biopsy?
  3. What are the concerns about the risk of bleeding during liver biopsies?

Doctor’s Tip

One helpful tip a doctor might give a patient about liver biopsy is to make sure to follow all pre-procedure instructions, such as fasting for a certain period of time before the biopsy. It is also important to inform the doctor about any medications or supplements being taken, as some may need to be temporarily stopped before the procedure. Additionally, it is important to follow all post-procedure care instructions to reduce the risk of complications and promote healing.

Suitable For

Patients who are typically recommended for liver biopsy include those with:

  1. Persistently abnormal liver function tests: When blood tests show ongoing liver damage or dysfunction, a liver biopsy may be recommended to determine the underlying cause.

  2. Suspected liver diseases: If imaging tests or blood tests suggest the presence of liver diseases such as hepatitis, cirrhosis, or fatty liver disease, a biopsy may be needed to confirm the diagnosis.

  3. Monitoring disease progression: For patients with known liver diseases, such as hepatitis C or autoimmune hepatitis, periodic liver biopsies may be recommended to monitor the progression of the disease and assess the effectiveness of treatment.

  4. Unexplained symptoms: In cases where a patient is experiencing unexplained symptoms such as abdominal pain, fatigue, or jaundice, a liver biopsy may be necessary to identify the cause.

  5. Evaluation of liver transplant candidates: Liver biopsies may be performed on patients who are being considered for a liver transplant to assess the severity of liver damage and determine the best course of treatment.

It is important to note that the decision to perform a liver biopsy should be made on a case-by-case basis, taking into consideration the patient’s overall health, the suspected diagnosis, and the potential risks and benefits of the procedure.

Timeline

Before liver biopsy:

  1. Patient is referred for a liver biopsy by their healthcare provider.
  2. Patient may undergo blood tests to assess liver function and clotting ability.
  3. Patient may have imaging studies, such as ultrasound or CT scan, to locate the best site for biopsy.
  4. Patient may be instructed to fast for a certain period of time before the procedure.
  5. Patient may receive sedation or local anesthesia to numb the area where the biopsy needle will be inserted.

During liver biopsy:

  1. Patient lies on their back or side on a procedure table.
  2. The healthcare provider cleans and numbs the skin over the biopsy site.
  3. A needle is inserted through the skin and into the liver to collect a small sample of tissue.
  4. Patient may feel pressure or a brief sharp pain during the procedure.
  5. The tissue sample is sent to a lab for analysis.

After liver biopsy:

  1. Patient is monitored for a few hours to check for any signs of bleeding or other complications.
  2. Patient may experience some pain or soreness at the biopsy site.
  3. Patient may be advised to avoid strenuous activities for a few days.
  4. Results of the biopsy are typically available within a week.
  5. Patient follows up with their healthcare provider to discuss the biopsy results and create a treatment plan based on the findings.

What to Ask Your Doctor

  1. What are the reasons for recommending a liver biopsy in my case?
  2. What information will the liver biopsy provide that other tests cannot?
  3. What are the potential risks and complications of having a liver biopsy?
  4. How should I prepare for the liver biopsy procedure?
  5. Will I need to stop taking any medications before the biopsy?
  6. How long will the liver biopsy procedure take, and will I need to stay in the hospital afterward?
  7. How soon will I receive the results of the liver biopsy?
  8. What will the recovery process be like after the liver biopsy?
  9. What are the possible outcomes of the liver biopsy results, and what treatment options may be recommended based on those results?
  10. Are there any alternative diagnostic tests or procedures that could be considered instead of a liver biopsy in my case?

Reference

Authors: Khalifa A, Rockey DC. Journal: Curr Opin Gastroenterol. 2020 May;36(3):184-191. doi: 10.1097/MOG.0000000000000621. PMID: 32097176