What is a liver biopsy?
A liver biopsy is a procedure in which tissue samples from the liver are removed for examination under a microscope to look for signs of damage or disease. It is used to diagnose many liver conditions. During a liver biopsy, tissue samples are removed with a special needle to determine if cancer or other abnormal cells are present, or to determine how well the liver is working.
There are three types of liver biopsies:
- Percutaneous or needle biopsy. After deep sedation and local anesthetic is given, the doctor inserts the special biopsy needle into the liver to obtain a sample. Ultrasonography may be used to guide the biopsy needle insertion. Most liver biopsies are performed using this technique. This is usually performed by a pediatric gastroenterologist.
- Laparoscopic or open biopsy. After a general anesthetic is given, the doctor makes an incision in the skin and surgically removes a piece of the liver. Depending on the lab findings, further surgery may be performed. This is usually performed by a pediatric surgeon.
- Transvenous biopsy. After a local anesthetic is given, the doctor makes an incision into a vein on one side of the neck and inserts a specially designed hollow tube called a sheath through the vein down to the liver. One or more tissue samples are removed through the tube. This is usually performed by an interventional radiologist.
Other related procedures that may be used to diagnose liver problems include abdominal ultrasound, CT scan of the liver and MRI of the liver. Learn more about these imaging procedures at CHOC.
What are the reasons for a liver biopsy?
A liver biopsy is useful to diagnose conditions of the liver that cannot be determined by symptoms or lab tests. When a person has an enlarged liver, jaundice (yellowing of the skin and eyes due to bile pigments in the blood) or abnormal lab tests that suggest liver disease, a biopsy may be done.
A liver biopsy may be performed to diagnose:
- Hepatitis. This is inflammation of the liver that sometimes causes permanent damage, resulting from viruses, drugs, alcohol, parasites, or other conditions. Learn more about hepatitis.
- Liver tumor. An abnormal lump or mass of tissue. Tumors can be benign (noncancerous) or malignant (cancerous).
- Fatty liver disease. A buildup of fat in liver cells. Learn more about fatty liver disease.
- Fibrosis of the liver. The growth of scar tissue due to infection, inflammation, injury, or even healing
There may be other reasons for your child’s doctor to recommend a liver biopsy.
What are the risks of a liver biopsy?
As with any surgical procedure, complications can occur. Some possible complications may include, but are not limited to, the following:
- Discomfort and bruising at the biopsy site
- Prolonged bleeding from the biopsy site, externally or internally
- Infection near the biopsy site
- Puncture of adjacent organs or structures.
If the liver biopsy is performed with the aid of X-ray technology, the amount of radiation used is considered minimal. Therefore, the risk for radiation exposure is low.
There may be other risks depending on your child’s specific medical condition. Be sure to discuss any concerns with your child’s doctor prior to the procedure.