Doctors can obtain a sample of liver tissue during exploratory surgery, but more often they obtain a sample by inserting a hollow needle through the person's skin and into the liver. This type of biopsy procedure is called percutaneous liver biopsy. Another type of biopsy procedure is called transvenous liver biopsy.
Liver biopsy can detect information about the liver that may not be evident from other tests. Doctors commonly use liver biopsy to detect excess fat in the liver (fatty liver Fatty Liver Fatty liver is an abnormal accumulation of certain fats (triglycerides) inside liver cells. People with fatty liver may feel tired or have mild abdominal discomfort but otherwise have no symptoms... read more ), chronic liver inflammation (chronic hepatitis Overview of Chronic Hepatitis Chronic hepatitis is inflammation of the liver that lasts at least 6 months. Common causes include hepatitis B and C viruses and certain drugs. Most people have no symptoms, but some have vague... read more ), metabolic liver diseases such as Wilson disease Wilson Disease In Wilson disease, a rare hereditary disorder, the liver does not excrete excess copper into the bile as it normally does, resulting in accumulation of copper in the liver and liver damage.... read more (an excess of copper) and hemochromatosis Overview of Iron Overload Iron is essential for life, so the body usually tightly controls iron absorption from food and recycles the iron from red blood cells. People lose small amounts of iron every day, and even a... read more (iron overload), complications following liver transplantation Liver Transplantation Liver transplantation is the surgical removal of a healthy liver or sometimes a part of a liver from a living person and then its transfer into a person whose liver no longer functions. (See... read more , and primary or metastatic liver cancer Metastatic Liver Cancer Metastatic liver cancer is a cancer that has spread to the liver from elsewhere in the body. Weight loss and a poor appetite may be the first symptoms. Doctors base the diagnosis on results... read more (cancer that has spread to the liver).
View of the Liver and Gallbladder
Percutaneous liver biopsy
Percutaneous liver biopsy can be done as an outpatient procedure. Doctors usually use ultrasonography to locate the liver and to guide the needle in order to obtain a biopsy specimen of an abnormal area. Once doctors identify the desired biopsy site, they anesthetize the person's skin and insert the needle into the liver. The hollow needle comes out with a tiny piece of liver tissue inside it.
After the specimen is obtained, the person remains in the outpatient department for 3 to 4 hours because of a small risk of complications, such as bleeding of the liver. Because bleeding can start up to 15 days after the biopsy, the person is instructed to stay within an hour's drive of the hospital during that period. Complications related to liver biopsy, though infrequent, can cause serious problems; 1 of 10,000 people die as a result of the procedure. Mild pain in the upper right abdomen, sometimes extending to the right shoulder, is common after a liver biopsy and is usually relieved by analgesics.
Transvenous liver biopsy
In another procedure, called transvenous liver biopsy, a catheter is inserted into a neck vein, threaded through the vena cava, and placed into one of the hepatic veins that drain the liver. A needle on the tip of the catheter is then inserted through the wall of the vein into the liver. This procedure is less likely to injure the liver than is percutaneous liver biopsy. It is especially useful in people whose blood does not clot properly or in people with portal hypertension Portal Hypertension Portal hypertension is abnormally high blood pressure in the portal vein (the large vein that brings blood from the intestine to the liver) and its branches. Cirrhosis (scarring that distorts... read more related ascites, both are complications of severe liver disease Liver Failure Liver failure is severe deterioration in liver function. Liver failure is caused by a disorder or substance that damages the liver. Most people have jaundice (yellow skin and eyes), feel tired... read more .