Liver biopsies often use needles to remove a small amount of tissue from the liver for examination. A doctor can use the biopsy to diagnose and assess conditions that affect the liver.

A liver biopsy can help provide information to a doctor about the health of a person’s liver. The doctor can use this medical test to identify the damage, assess its extent, and help diagnose conditions that affect a person’s liver.

This article looks at the types of needles that doctors use for liver biopsies and explains what to expect from a liver biopsy.

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A liver biopsy needle helps doctors collect a small sample of tissue during a percutaneous liver biopsy. This is a specific type of liver biopsy that involves inserting a needle into a person’s abdomen.

Doctors also use needles in a transjugular liver biopsy, during which they insert a needle into a vein in a person’s neck.

After collecting a tissue sample, the doctor will send it to a lab for analysis. When the results come back, they can use the information to guide treatment or determine whether additional testing is necessary.

For a liver biopsy, experts suggest using either an aspiration needle or a cutting needle.

Both of these can collect tissue samples from the liver, but they operate differently. The choice of liver biopsy needle may depend on the facility and the availability of the needles.

There are two main types of needles that doctors may use during a liver biopsy:

  • A cutting needle: This type has a side notch that rests against the liver and an outer sheath that cuts off a small portion of the tissue. One example is the Tru-Cut needle, which manufacturers design specifically for this purpose.
  • An aspiration needle: This is a thin, hollow tube that collects a small sample through suction. Examples include Menghini and Jamshidi needles.

The size of the needle can vary.

A doctor will likely discuss size in terms of gauge, with smaller numbers indicating larger needles and higher gauges referring to smaller needles.

Some evidence suggests that larger needles have a higher tendency to cause complications, such as bleeding. However, this is based on animal studies, and researchers have not yet replicated this finding in trials involving humans.

The BMJ reports that in an older study of 68,276 percutaneous liver biopsies, the Tru-Cut needle had a higher rate of complications than the Menghini needle. However, both rates were low, with complications affecting 0.3% and 0.1% of procedures, respectively.

This shows that a liver biopsy is generally a safe procedure.

A person can ask a doctor which type of needle they will use for the biopsy and discuss the associated risks with them.

Prior to making any incisions or inserting the needle, the doctor will numb the area with a local anesthetic. This will prevent a person from feeling pain from the incision or the needle.

However, a person may feel some pressure or mild discomfort as the doctor pushes the needle into the body.

Following the procedure, pain is the most common complication. People can manage this by taking pain relievers.

There are different options for a liver biopsy procedure, two of which — percutaneous and transjugular — require a liver biopsy needle.

This section looks at what to expect from these two procedures.

Percutaneous liver biopsy

A percutaneous liver biopsy involves inserting the biopsy needle through a small incision in the abdomen.

Prior to the procedure, a doctor may give the person specific instructions, such as stopping certain medications or avoiding food and drink for a certain period.

The procedure typically involves the following steps:

  1. A person will need to lie on their back or their left side. A doctor will then clean the abdominal area with antiseptic.
  2. The doctor then numbs the area by injecting a local anesthetic. They usually inject the skin on the person’s right side, between the two lower ribs.
  3. The doctor will then make a small incision and insert the needle through the opening to reach the liver and take a tissue sample with the needle.

Following the procedure, a doctor will want to observe the person for 2–6 hours to make sure that they do not have any immediate adverse reactions. In most cases, a person will be able to return to their normal activities within 24 hours.

A person should discuss this in more detail with the doctor carrying out the procedure.

Transjugular liver biopsy

A transjugular liver biopsy involves inserting the needle through a tube placed in the jugular vein in the neck. A doctor snakes the tube through to the liver and then threads the needle through the tube.

Preparation for the transjugular liver biopsy is similar to that for the percutaneous liver biopsy. A person should discuss the procedure and the necessary preparation with the doctor.

The procedure is as follows:

  1. A person will need to lie on their back. The doctor will then numb one side of the neck and make a small cut.
  2. The doctor will insert a length of flexible hollow tubing through the cut and into the jugular vein. They will then inject some dye into the tube to see the vein more clearly.
  3. The next step is to insert the needle through the tube until it reaches the liver, where the doctor will take a sample.
  4. They will then carefully remove the needle and tube and cover the area with a bandage.

Following the procedure, the person will likely need to stay for 2–6 hours for observation before going home. They should be able to resume normal activities within 24 hours.

Learn more

Learn more about liver biopsies.

Once the doctor has retrieved the sample from the liver, they will send it to a lab. If the hospital does not have an integrated lab, they may need to deliver the sample through a delivery service.

When the sample reaches the lab, a person can expect to wait at least a few days for the results to come back. In most cases, the lab will send the results directly to the doctor’s office.

Depending on the facility, a person may be able to access their results through an online portal. Otherwise, the doctor will either call with the results or schedule a follow-up appointment.

What do they mean?

The results of a liver biopsy can tell a doctor several things about the liver, including:

  • whether a disease or another disorder is affecting the liver
  • the extent of scar tissue in the liver
  • whether any treatments currently underway are effective

A person’s doctor will explain the results and talk with them about the next steps, which may be treatment or additional testing.

Learn more about liver biopsy results.

Below, we answer some common questions about liver biopsy needles.

What is a Chiba needle?

A Chiba needle is the most common type of aspiration needle that doctors use in biopsies and percutaneous access. It is a hollow needle with a 30-degree beveled tip.

What is a biopsy gun?

A biopsy gun is a type of cutting needle that uses a semi-automatic cutting action to remove a piece of tissue from the liver or other soft tissue. It allows for relatively quick removal of the sample.

Where does the doctor insert a liver biopsy needle?

Depending on the procedure, a doctor may insert the liver biopsy needle into a person’s abdomen or neck.

In both cases, the doctor will numb the area first using a local anesthetic.

Doctors use liver biopsy needles to remove a small sample of tissue from the liver. The primary types that doctors use in liver biopsies are cutting needles and aspiration needles. Both can remove a small sample for the doctor to send to the lab.

Once the lab has the sample, it will take a few days for the results to come back to the doctor’s office. The doctor will use the results to guide the next steps, which may involve treatment or further testing.