I was newly diagnosed with Hep C with all the blood work results, but there was still a piece of the puzzle missing. My doctor told me I needed a Liver Biopsy. I quickly asked, “Why”? He explained, “A liver biopsy is a good way to see the structural condition of the liver.”
From the Hep C Patients perspective, knowing what to expect dispels fear of the unknown. Personally I relax and feel less stressed about procedures when I know what to expect. If your doctor has informed you that you need a liver biopsy, get the facts and ask questions. Above all don’t worry. This Proactive test will help you and your doctor make the best decisions about your liver health.
5 Basic Facts about a Liver Biopsy
1. What is a liver biopsy?
A liver biopsy is a medical procedure, normally outpatient, where a small piece of liver tissue is removed so the doctors can examine the structural condition of the liver.
2. Why is a liver biopsy done?
American Liver Foundation states, a liver biopsy is an accurate way to learn the condition of your liver when other tests indicate that your liver is not working properly. In short, the liver biopsy gives detailed information about your liver. It helps your doctor:
- Diagnose liver disease and the stage it is in.
- Determines if fibrosis or cirrhosis is present.
- Detect cancer and infections.
- Provide reasons for liver swelling or abnormal levels of liver enzymes.
- This information helps guide treatment decisions.
The procedure is done through outpatient or hospital facility.
A blood test will be done to make sure your blood clots properly. You cannot eat or drink 8 hours prior to having the liver biopsy.
Your doctor needs to be informed of:
- all your prescription medications you take including non-prescription over the counter medications, vitamins and herbal supplements
- bleeding problems you may have
- if you are pregnant
- Asprin, Ibuprofen (example, Advil, Motrin, or others) and certain pain relievers
- Blood thinners such as Warfarin (Coumadin)
- Certain dietary supplements that may increase risk of bleeding
4. How is the liver biopsy done?
There are four ways liver biopsies are done.
*Percutaneous biopsy or needle biopsy. The percutanceous (through the skin needle) biopsy is the most common procedure done. This is a quick procedure where a needle inserted near the bottom of your right rib cage retrieves a very small liver sample.
Light sedation is given to alleviate the fear of discomfort but it is important for the patient to be fully conscious in order to take a deep breath and hold it for a few seconds while the needle very quickly takes the liver sample. This happens so fast you barely notice it and its over.
*Transjugular biopsy. A small incision in the jugular vein with a tube threaded down to the hepatic vein and a biopsy needle retrieves a small liver sample. This procedure is performed with X-rays, and contrast dye.
*Laparoscopic biopsy with general anesthetics. A small incision is made in the abdomen to take liver samples.
*Fibroscan, a brand new method; approved in 2013 in the US, the Fibroscan is performed with ultrasound. A non invasive procedure.
Your doctor will choose the best procedure for you.
5. What is recovery like?
After the liver biopsy procedure, if you have had a Percutaneous/needle biopsy, you will go to recovery and lay on your side for several hours to lower the chance of bleeding since the liver is very vascular. Your blood pressure, pulse and breathing will be monitored for several hours then you may go home.
If you have had a Transjugular biopsy you may stay longer in recovery. If you have had a Laparoscopic biopsy, your doctor may recommend to be monitored overnight in the hospital since this procedure is more invasive.
You will need to have someone drive you home after the procedure and take it easy the rest of the day. No lifting or exercise for 24 hours. If you had a Fibroscan since there is no incision or needle insertion you may immediately resume normal activity.
Being a Hep C patient, I have had two Percutaneous/needle liver biopsies. My first was in 1994 and the second after 2000. Both times were fast and easy. I did not have any complications and would not hesitate to do it again if it were necessary.
Have you ever had a Liver Biopsy, if so which type? Do you have any questions or concerns about a Liver Biopsy?
This entry was originally published on Life Beyond Hepatitis C November 20. It is reprinted with permission.