A liver biopsy is a test that allows doctors to examine tissue from the liver under a microscope. It can test for several severe medical conditions, including cancer. A doctor may recommend a liver biopsy if a person has symptoms of liver disease, but it is not clear what is causing the symptoms.
A liver biopsy is not a routine medical test or something a doctor might recommend as part of an annual checkup. Instead, doctors
During a liver biopsy, a healthcare professional inserts a long, thin needle into the liver and removes a small quantity of tissue. A pathologist then examines the tissue under a microscope for signs of disease.
This article discusses liver biopsy tests and why doctors perform them. We also examine the risks and procedures of a liver biopsy test and what the results could mean.
A liver biopsy allows a doctor to look at a sample of liver tissue under a microscope, helping to
It can also help a doctor distinguish several potential causes of liver health issues. For example, a doctor might use a liver biopsy to determine whether a person has nonalcoholic fatty liver disease or autoimmune hepatitis.
More than 95% of people who undergo a liver biopsy have a successful test. The overall
Still, it is not a risk-free procedure, so people should discuss the risks and benefits of the test with healthcare professionals — especially older adults and people with health conditions.
- pain after the procedure, which most people experience
- bleeding, which is rare in people with cancer (0.57%), and rarer in those without cancer (0.16%)
- bacteria in the bloodstream, which usually resolves on its own
- serious bacterial infection in the liver or surrounding areas
- very rarely, complications such as heart injuries or a collapsed lung
A person will need blood tests within a month of a liver biopsy to assess whether they have any conditions that increase their risk of bleeding or other complications. They should inform a doctor about their current medications or supplements and continue taking them daily unless a doctor advises otherwise.
Doctors usually advise stopping taking aspirin, blood thinners, and nonsteroidal anti-inflammatory drugs (NSAIDS) 1 week before a biopsy. These can increase the risk of bleeding. They may also instruct a person not to eat or drink anything after midnight the night before the procedure.
A person may feel groggy from the sedation after a liver biopsy, so they must arrange for someone else to drive them home.
Doctors perform three different types of liver biopsies, as follows:
Percutaneous liver biopsy
A percutaneous liver biopsy is the most common approach to liver biopsy. During the procedure, a person is awake, and a doctor
A doctor injects lidocaine into the area around the liver. They make a tiny incision along the ribs, then insert a needle into the incision. A doctor may give directions during the procedure. For example, a person may need to hold their breath briefly when the needle goes in.
Most people do not feel pain, but they may feel a dull ache or shoulder pain.
Transvenous liver biopsy
A transvenous liver biopsy allows doctors to
First, a doctor numbs the area where a needle will enter a blood vessel. Then, they insert the needle into a blood vessel, often in the neck. Using a fluoroscope machine that provides images of the inside of the body, a doctor slowly moves to the liver, then takes a sample.
Laparoscopic liver biopsy
Doctors typically perform a laparoscopic liver biopsy in an operating room on a person under general anesthesia. However, a doctor may perform this as an outpatient procedure with moderate sedation.
A doctor makes a
People often worry about pain during a liver biopsy. In most cases, a person only feels a brief prick from the needle a doctor uses to numb the area and not intense pain. When the area goes numb, it may feel tingly.
A person who has a laparoscopic procedure will not feel anything after a doctor gives them anesthesia.
After the procedure, a person may have some aching or pain, but the pain should not be intense or unbearable.
Regardless of the type of liver biopsy a person has, guidelines from the
A person should call a doctor if they have intense pain, feel very weak, or feel very sick. Before the test, they should ask a doctor what signs and symptoms indicate an emergency.
A normal liver biopsy shows:
- no signs of scarring or fibrosis in the liver
- no significant fat accumulation in the liver
- no signs of cancer or abnormal cell growth
- no inflammation or signs of the hepatitis virus
- no abnormal levels of copper, which could indicate Wilson’s disease
Abnormal liver biopsy results may provide evidence for several different diseases, such as:
- liver cirrhosis
- liver cancer
- autoimmune hepatitis
- viral hepatitis
- Wilson’s disease
- nonalcoholic fatty liver disease
A liver biopsy can help diagnose several medical conditions and may help distinguish one from another. A doctor may recommend it if a person has an abnormal liver ultrasound, abnormal liver blood work, or significant risk factors for liver cancer or other serious liver diseases.
People considering a liver biopsy should discuss the risks and benefits with a doctor and ask about alternatives. For most people, a liver biopsy is a safe procedure and unlikely to cause severe pain.