The liver is a very large organ in the right upper abdomen. In fact, most of the liver lies behind the ribs in the right-lower chest. The liver is remarkable, quietly making many proteins, eliminating waste products, and participating in the general metabolism and nutrition of the body. There are many different problems that can occur in the liver. These include viral infections, reactions to drugs or alcohol, tumors, hereditary conditions, and problems with the body's immune system.
The physician will always take a medical history and perform a physical exam. Blood studies, known as liver function tests (LFT), give an overview of the health of the liver. If LFT results are persistently abnormal, the physician will then perform additional medical studies to determine the exact cause of the problem. This is particularly important because there are now effective treatments for many chronic liver disorders. Finally, the physician will want to know not only the specific cause of the problem, but also the severity of it. The liver biopsy helps answer these questions.
A biopsy is a small sample of body tissue. This tissue is prepared and stained in a laboratory. The physician can then view it under a microscope. By so doing he or she can often make a specific diagnosis and determine the extent and seriousness of the condition. This information is often vital in determining the treatment.
The liver biopsy is usually performed on an outpatient basis. At times, an ultrasound or echo machine is used to identify the best location to make the biopsy. Usually, the physician can make this determination simply by examination. The patient lies quietly on the back or slightly to the left side. In some instances, the patient will be given some mild sedation at this point. The physician usually reaches the liver through the lower-right chest between the ribs. That area is first carefully cleaned. A local anesthetic agent like Novocain is used to numb the skin and tissue below. A specially designed thin needle is inserted through the skin. At this point, the physician will tell the patient how to breathe. The needle is quickly, advanced into and nut of the liver, taking only 1 or 2 seconds. A slender core of tissue is thereby obtained which is then processed through the laboratory. The entire procedure from start to finish lasts only 15 to 20 minutes.
The patient is kept at rest for several hours following the exam. Medical personnel check the heart rate and blood pressure. At times, there is some discomfort in the chest or shoulder. This is usually temporary and medication is available if needed. The patient is given instructions regarding activity and eating before being discharged home. Activity is usually restricted for a day or so afterward.
In most instances, a liver biopsy is obtained quickly with no problems. As noted, there is occasionally some fleeting discomfort in the right side or shoulder. Internalbleeding can sometimes occur, as can a leak of bile from the liver or gallbladder. These problems are usually handled conservatively without the need for surgery.
A liver biopsy is a simple, rapid method of obtaining a sample of liver for analysis. This information is of great importance in guiding the physician in his or her evaluation and treatment. While some complications occur, they are unusual. The benefits of the exam always outweigh the risk. With the biopsy information, effective and specific therapy can usually be provided to the patient.