Ultrasound guided liver biopsy
What is a liver biopsy?
A liver biopsy is a common procedure. It is when a needle is inserted into your liver through your skin, and a small sample of liver tissue is removed. The sample is looked at under a microscope and is used to help your doctor treat you.
Risks and benefits
You will benefit from this procedure because it will help us to investigate your symptoms and decide what the best treatment is for you. It is a safe and short procedure which means you only need to remain in hospital for a day.
Sometimes there is some bleeding from the biopsy site—this is usually a small amount and soon stops. Occasionally the bleeding is more severe, and rarely a blood transfusion or an operation will be required to help you. Very rarely, the bile produced by the liver may leak around the liver. This should go away itself but may require draining. There is a small risk that the needle site will become infected after the biopsy.
We will discuss all of the risks and benefits with you in detail before your procedure.
Before you come in
Please let your doctor know if you take warfarin (tablet to thin the blood) or have any allergies.
A few days before your liver biopsy you will need to have a blood test to check how well your blood will clot. This is to make sure that you are not likely to bleed following the biopsy. Unfortunately, your liver biopsy cannot be done if your blood has not been taken. Please find the instructions on how to do this in your appointment letter.
You will be spending about four hours resting in bed after your procedure, so you might like to bring a book or magazine into hospital with you. Please arrange to have an escort home after your procedure and a friend or family member (this must be a responsible adult) to stay with you until the following day. This is very important otherwise you may not be able to have your liver biopsy.
What happens on the day of my appointment?
You may have a light breakfast (such as tea or coffee and toast) before 6am. After 6am please do not eat or drink until after your biopsy. Please take all your medications as usual (except aspirin or warfarin).
Your letter will tell you where you will be admitted Please make sure you arrive at 8:30am. If you are late, it may not be possible to do your procedure and you will have to make another appointment.
Before the procedure
On the ward your nurse will ask you several questions about your health and current medication. They will check your blood pressure and pulse and ask you to change into a gown. Your nurse will bring you to the X-ray Department on your bed.
During the procedure
In the procedure room you will be seen by your doctor—this is an opportunity to discuss the procedure before signing a consent form. Please ask any questions you may have as it is important that you understand what is going to happen.
You will remain on your bed for your biopsy. The doctor will use an ultrasound guide to decide on the best location to insert the biopsy needle (usually between your two lower ribs on your right hand side). Your skin will be cleaned with antiseptic fluid and you will be covered with a sterile sheet.
The doctor will give you an injection of local anaesthetic which will cause some stinging initially and then go numb. A nurse will be with you who will monitor your pulse and blood pressure. Please let the nurse know if you feel any discomfort.
The biopsy needle will be inserted through your skin into your liver and a sample will be collected. You will have to hold your breath for 5-10 seconds when asked, as the liver moves slightly when you breathe.
A small dressing will be placed over the needle site. The procedure takes about 30 minutes to complete but may take longer.
Following the procedure
You will go back to the ward where your nurse will record your pulse and blood pressure as well as check the needle site regularly. You may feel some discomfort around the biopsy site and pain in your right shoulder.
You will be required to rest in bed for a further three hours. If you feel unwell at any time, please tell your nurse.
Going home
Once your nurse is happy that you have recovered completely from your biopsy you will be discharged from hospital and your friend/family member can take you home.
After you are home
- Rest quietly at home for the remainder of the day and the following day.
- The waterproof dressing may remain on for 3–4 days. Avoid baths over this time until the skin site is healed. You may only shower.
- You must avoid excessive activity or lifting anything greater than 5kg (11 lb) for the next
- 5–7 days. If your job involves heavy manual work you are advised to take the week off. Please let your nurse know if you need a medical certificate.
- If your job doesn’t involve any manual work or lifting, you can return to work two days after the biopsy.
- Please contact your GP if you experience any pain on breathing, severe pain in your stomach, or a high temperature.
Contact information
Chelsea and Westminster Hospital
Interventional Radiology Department
1st Floor, Lift Bank D
T: 020 3315 8570/8582
If you need to change your appointment time or date, please contact the Imaging Department on 020 3315 8570 as soon as possible.