Liver Biopsy
A hepatologist or gastrosurgeon can perform a liver biopsy. A qualified doctor does a liver biopsy. Your surgeon may insert a small needle into the liver to collect a sample piece of the liver. Doctors can evaluate liver damage.
Why liver biopsy?
A liver biopsy is a process that involves inserting a tiny needle into the liver to extract a small sample. The liver sample is then tested in a path lab to assist doctors in diagnosing liver illnesses or abnormalities. Many doctors perform liver biopsies to evaluate diseases like cirrhosis. They can detect infection, inflammation, or cancerous cells. The liver is a vital organ. Many doctors perform liver biopsies to diagnose things like cirrhosis. They can detect infection, inflammation, or cancerous cells. If blood or imaging tests reveal abnormalities in your liver, your hepatologist may recommend a liver biopsy. Your surgeon performs a liver biopsy to determine how much damage the liver has sustained from fibrosis (thickening or scarring). To diagnose liver diseases like hepatitis, cirrhosis, fatty liver disease, or tumours and monitor disease progression.
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| healthy liver care |
They performed a liver biopsy to identify the cause of
- Hepatitis.
- Liver tumour.
- Fatty liver
- Fibrosis of the liver
- metabolic or autoimmune disease.
- Your abnormal levels of liver enzymes during blood tests
- Unexplained yellowing of the skin (jaundice).
- Doctors discover abnormalities in your liver during ultrasounds, CT scans, and nuclear scans.
- Hepatomegaly Liver enlargement (cirrhosis)
What does the liver do?
The liver's location is on the right upper side of the abdomen, behind the lower part of the rib cage. Experts treat the liver as the largest vital organ in the body. It performs many functions, including:
- The liver works on protein development to help with blood clotting, carrying oxygen, and aiding the immune system.
- It detoxifies the body from harmful substances in the bloodstream, including drugs and alcohol.
- It breaks down saturated fat and produces cholesterol.
- Your liver stores nutrients and returns them to the bloodstream.
- Your liver produces bile, a chemical necessary for food digestion.
- It assists the body in the storage of sugar (glucose) in the form of glycogen.
Your liver does many things the body needs to function and survive, such as:
- It produces proteins and enzymes responsible for essential metabolic processes.
- It cleans your blood of impurities.
- It aids in infection control.
- Keep the required vitamins and nutrients in your store.
A liver biopsy can reveal whether your liver has cancer or other malignant cells. It can also tell you how healthy your liver is.
How is a hepatic biopsy performed?
There are three types of liver biopsies:
Percutaneous liver biopsy.
The most common method by which your surgeon administers local anaesthesia is. They may insert a tiny needle into your liver to take a sample.
Laparoscopic liver biopsy.
Your surgeon administers local anaesthesia. They may put a narrow, lightweight tube (laparoscope) into your skin through a tiny cut or incision. This tube has a small video camera attached to it. Your surgeon can see the inside of your belly on a computer screen. A needle is put through another pipe to remove the sample.
Transvenous liver biopsy.
Doctors may use this technique if you have blood-clotting problems or fluid in your belly. Your surgeon administers local anaesthesia, and then they make an incision into a vein in your neck. Doctors use a hollow tube through the vein down to your liver. Your gastroenterologist will utilize X-rays and a contrast dye in the pipe. The use of colour is shown more clearly on the X-rays. They put a needle through the thin tube to your liver to extract tissue samples through the pipe.
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What happens on the day of the hepatic biopsy?
Before the procedure,
- Your surgeon may advise you not to eat or drink anything 4-6 hours before the procedure.
- Your doctor will explain the biopsy procedure in detail, including possible complications, and answer any questions you may have.
- Doctors administer a minor tranquillizer to relax. As a result, having a family member or friend with you on exam day is essential.
During the percutaneous liver biopsy procedure,
- Your doctor may ask you to lie on your back with your right elbow out to the side. They may advise you to keep your right hand above your head. During the operation, you must be calm.
- Your doctor may use an ultrasound technique to mark the location of your liver.
- Your doctor may use a local anaesthetic to clean and numb the area in your upper abdomen (pain-relieving medication). The doctor immediately makes a small incision (cut) in your upper belly (less than 5 mm) and inserts a needle into it to take a small sample of liver tissue for investigation.
During the transvenous liver biopsy procedure,
- Your gastrosurgeon may ask you to lie on your back.
- You must remain as still as possible during the test.
- Your doctor numbs the side of your neck and makes a small (less than 5 mm) incision.
- Your surgeon will insert a special hygienic syringe into the incision and advance it to the liver, where they use a needle to take a liver sample.
What are the possible risks or complications of liver biopsy?
While a liver biopsy is generally safe, it does carry some risks and potential complications. These include:
- Pain: The most common side effect, usually mild to moderate, occurs at the biopsy site or right shoulder. Pain typically subsides with over-the-counter pain relievers.
- Bleeding: There is a small risk of bleeding from the liver, which could require a blood transfusion or, in rare cases, surgical intervention.
- Infection: Though rare, there is a chance of infection at the biopsy site or within the abdominal cavity.
- Injury to Nearby Organs: There is a slight risk of accidentally puncturing nearby organs like the gallbladder, lung, or kidney.
- Pneumothorax: In cases where the needle punctures the lung, air can leak into the chest cavity, causing a collapsed lung, which may require additional treatment.
- Bile Leakage: Injury to bile ducts can lead to bile leakage, causing pain and potential complications like bile peritonitis.
- Severe Complications: Very rarely, liver biopsy can result in life-threatening complications, primarily due to excessive bleeding.
Doctors take careful precautions to reduce risks, such as reviewing the health history and using imaging guidance during the procedure.
What are the recent developments in liver biopsy tests?
Recent developments in liver biopsy testing have focused on enhancing precision, reducing invasiveness, and reducing patient risk. Here are some significant advancements:
- Non-Invasive Alternatives: Imaging-based techniques, such as transient elastography (e.g., FibroScan), magnetic resonance elastography (MRE), and contrast-enhanced ultrasound, are being increasingly used to assess liver stiffness, offering a less invasive option than traditional biopsies.
- Liquid Biopsy: A promising alternative, this approach detects liver disease biomarkers in blood samples. It can identify early signs of liver fibrosis, cirrhosis, and even liver cancer with minimal invasiveness and high accuracy.
- AI and Machine Learning: AI is improving the diagnostic accuracy of liver biopsy analyses by enabling advanced imaging and pattern recognition, helping clinicians assess fibrosis, steatosis, and inflammation with greater precision.
- Enhanced Imaging-Guided Biopsies: Ultrasound and CT-guided biopsies have advanced with better resolution, improving biopsy accuracy and reducing complications by ensuring safer needle placement.
- Molecular and Genetic Testing: Molecular profiling on biopsy samples allows for individual medicine approaches, tailoring treatment based on specific genetic markers associated with liver diseases, including non-alcoholic fatty liver disease (NAFLD) and liver cancer.
- Combination Biomarker Panels: Research is increasingly validating biomarker panels like APRI (AST to Platelet Ratio Index) and FIB-4, which, when combined with imaging, offer non-invasive methods to predict liver damage levels and monitor disease progression.
These advancements help make liver biopsies safer and more efficient while paving the way for early and accurate liver disease detection.