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Printed at: 08:55:01 / 15-05-2021

Liver biopsy

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This information sheet will explain the examination you are going to have. It is also very important that you follow the instructions from your hospital Consultant.

What is the purpose of a liver biopsy?
Your Consultant has asked us to perform a liver biopsy (sample of tissue from your liver), to allow a definite diagnosis to be made. The information gained from the liver biopsy will also help your consultant plan future treatment for you.

Will I need to stay in hospital?
Patients that require an ultrasound or x-ray guided liver biopsy normally have to be admitted to a ward the night before the procedure to allow sufficient preparation prior to the procedure, very rarely patients are admitted on the day of the procedure.

Do I need to do anything before the exam?
It is very important that you do not eat or drink anything for 6 hours prior to your x-ray appointment. However, you must continue to take any essential medication. (You may take your tablets with a small drink of water.) If you are diabetic, you will be advised about your medication by the medical staff. Please telephone the department on 01908 996934 for advice if you take aspirin or any drug that makes you bleed more easily.

What will happen on the ward?
On arrival to the ward you will be asked if you still agree to have the biopsy and to sign a form allowing us to perform the procedure, if you have not signed one already. Prior to the procedure you will be changed into an examination gown. Your blood pressure and pulse will be taken. It is important that you are awake during the procedure and are able to respond to our requests. You will be collected by the Imaging Assistant who will bring you to the x-ray department on a trolley or bed. If you ordinarily take a GTN spray or an inhaler you must bring these with you to the x-ray department.

What will happen in x-ray and who will be present during the procedure?
When you arrive, you will be greeted by the staff working in the department. They will check your details and ask you if you are allergic to anything. You may remain on a trolley for the procedure or you may be transferred from the trolley to the x-ray table. A Radiologist (a doctor who specialises in x-rays) will carry out the procedure.

Will I feel anything during the procedure?
The radiologist will numb the area at the site of the biopsy with some local anaesthetic. When this is done you will feel a sharp pain, but only temporarily, then the area will become numb.

What will the Radiologist do next?
The radiologist will perform an ultrasound examination over the area where the biopsy will be taken. This involves using some warm gel on an ultrasound probe placed onto the skin. Once the radiologist has located the best area to perform the biopsy, they will mark the area with a skin marker to guide them where to inject the local anaesthetic. The radiologist then injects the local
anaesthetic and will wait for the area to go numb. They may make a small cut in the skin and the biopsy will then be taken. The Consultant will take as many samples as necessary to ensure an accurate diagnosis. The biopsy needle is worked by a spring mechanism inside a small disposable biopsy gun. When the mechanism is fired it makes an unusual noise that the Radiologist may demonstrate to you before the procedure. This is to familiarise you with the noise and to let you know that the noise is normal and nothing to worry about.

How long will the procedure take?
This varies from patient to patient but usually it will take approximately 20 minutes.

What happens after the biopsy?
You must remain in bed for the next three hours and will not be allowed to eat or drink anything during this time. Sometimes you may be asked to lay on your right side. This is to ensure that there is no bleeding from the site of the biopsy. A nurse will take your blood pressure and check the puncture site on a regular basis. After several hours you will be allowed to get out of bed. You may be
allowed to go home later in the day if you are medically fit.

What are the possible complications?
With any procedure there may be some risks, these include: –

1. Infection – All the equipment used is sterile and for single use only so it will be disposed of at the end of the procedure.
2. Bleeding – Your blood will be tested before the procedure to check for any clotting abnormalities, any problems will be dealt with prior to the procedure. It is common for patients to bleed a small amount after this  procedure. Severe bleeding is rare (0.35-0.5% of patients)
3. Pain – It is common for patients to feel some discomfort after the procedure. It is uncommon for patients to experience severe pain (1.5% of patients)

Although extremely rare there are reported cases that patients have died as a result of this procedure. (0.01-0.17%)

All these complications are uncommon and we will do everything to minimise the chance of anything happening to you.

How will I get the results?
The specimens are taken to the laboratory straight after the procedure where they will be tested thoroughly. The results should be available in 7 – 10 days. Your consultant will contact you or your G.P regarding the results.

Any further queries?
Our contact number is 01908 996934 and we are available from 8.30 am until 5 p.m. Monday to Friday. Please do not hesitate to contact us, we will be happy to answer any queries you may have.

This leaflet has been adapted from the British Society of Interventional Radiology (BSIR) and the Clinical Radiology Patients’ Liaison Group (CRPLG) of The Royal College of Radiologists.