What, Why and How of Liver Biopsies: Explained | Cincinnati Children's

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What, Why and How of Liver Biopsies: Explained
A GlobalCastMD production

Batul Kaj-Carbaidwala, MD
Advanced Liver Fellow

Hi, my name is Batul Kaj-Carbaidwala, and I’m the advanced liver fellow here at Cincinnati Children’s. Today, I'm going to be going over the what, why and how of liver biopsies.

So, what is a liver biopsy, and why might someone need one? It’s a relatively safe and effective way to get a sample of liver tissue that we can then look at under a microscope. It’s commonly used to evaluate patients with things like abnormal liver tests, liver enlargement and jaundice, to name just a few.

The procedure is important because it can help your medical team figure out what the problem is, and how to treat it.

The biopsy can be done either by a liver doctor or an interventional radiology doctor. It’s usually decided by your team depending on your age and other medical problems.

So, let’s take a look at the process step by step. First, the patient is brought into the OR and anesthetized so they are asleep throughout the procedure. Then we clean the skin on the right side of the abdomen and drape to make sure that everything is safe and sterile. Next, we take our time to carefully determine where we will insert the needle.

If a liver doctor is performing the procedure they will use anatomical landmarks to find where to insert the needle. An interventional radiology doctor will instead use ultrasound to guide the needle insertion.

Next, the local anesthetic is injected at the injection site and then a very small cut is made in the skin using a scalpel. Finally, the biopsy needle is then inserted through the cut skin and the abdominal muscle layer into the liver and quickly and smoothly pulled back out.

This usually gives us all of the tissue we need, but sometimes a second or even third attempt is necessary.

After the procedure, the patient will need to lay flat for six hours to reduce the risk of bleeding. We like to observe the patient overnight and check their vitals including heart rate and blood pressure frequently. During this time the patient can usually eat and drink if they feel well enough.

It is normal to experience mild pain at the biopsy site for a few days after the procedure. However, if the pain is getting worse or is significant from the start we might check bloodwork and imaging to make sure that there are no signs of bleeding.

The following day the patient will usually be discharged home, unless the biopsy findings mean that the treatment needs to be started right away.
Thanks for watching. If you’d like more information about liver biopsies, please call us at (513)-636-4955 or talk with your providers during your next appointment.