Liver Biopsy
- Interventional Radiology
About this procedure
This guide provides information about a liver biopsy procedure. It includes details about what is involved, how to prepare and what to expect during and after the procedure. Please use this in addition to information from your doctor and nurse.
A liver biopsy is performed in an interventional radiology suite at IntraCare in Epsom. Your interventional radiologist will be assisted by our team of nurses and other highly skilled personnel.
Both IntraCare and Allevia Hospital will be involved with your care for this procedure. Allevia Hospital are responsible for your admission, preparation and aftercare.
What is a liver biopsy?
A liver biopsy is the sampling of tissue from the liver to diagnose, assess the severity of a disease, or monitor the progress of current treatment. At IntraCare, liver biopsies are predominantly performed on tumours/lesions for diagnostic purposes to help determine treatment options.
Before the procedure
Pre-procedure phone call
A nurse from IntraCare will call you 24–48 hours prior to your procedure to discuss the following information:
- Your admission time.
- When you should stop eating and drinking.
- Medication instructions.
- Allergies (including medications, contrast dye, dressings/plasters and food).
- Answer any further questions.
Anticoagulation (blood thinner)
If you are taking any blood thinners (e.g. Warfarin, Clexane, Pradaxa, Rivaroxaban), please make this known to IntraCare staff at the time of booking. Your interventional radiologist will advise you if you need to stop this medication temporarily for a few days before the procedure.
Other regular medications
Please continue to take these unless advised otherwise by your interventional radiologist. If you are taking a diuretic or water pills (e.g. frusemide, spironolactone), you may need to withhold this on the morning of the procedure.
Reminders for the day of your procedure
- If you are on regular medication, please bring this with you in its original packaging.
- Please leave all your jewellery and valuables at home. You are welcome to bring your mobile phone in with you.
- We recommend wearing loose-fitting clothing and shoes that are easy to slip on/off.
- You are encouraged to bring a friend or a family member as a support person before and after your procedure.
- This is commonly a day stay procedure, but please bring an overnight bag with you in case you are required to stay overnight.
- The planned procedure time is an estimate only and may vary. We will keep you informed of any unexpected delays on the day.
Informed consent
As with any procedure, there are potential risks involved. Your interventional radiologist will explain the procedure, discuss possible risks and answer any questions you may have. Your whānau or support person are welcome to be part of this discussion. You will then be asked to sign the consent form. This will occur either at an earlier appointment or on the day of your procedure.
Your procedure
Preparation
You will be collected by an IntraCare nurse from ADU, Allevia Hospital to IntraCare for your procedure. A small intravenous (IV) line will be inserted into a vein in your arm for medication to be injected. IV sedative and pain relief will be given to help you relax and keep you comfortable during the procedure.
Other devices for monitoring blood pressure, heart rate and oxygen levels will be fitted to ensure your safety during the procedure.
The procedure
The interventional radiologist will complete pre-biopsy imaging using ultrasound. Once location is marked, your abdomen will be prepared with an antiseptic solution. A sterile drape will then be placed over your body to ensure sterility is maintained.
Local anaesthetic will be injected in the area of the biopsy. You will feel the local anaesthetic injection around the biopsy area of your skin. More anaesthetic is then injected deeper into your tissue, closer to the lesion that will be biopsied. This will sting for approximately 30 seconds. If at any time you feel pain or discomfort, please inform the interventional radiologist immediately, and more pain relief can be given via your IV line, as well as more local anaesthetic.
Just before the biopsy is taken, you will hear a loud noise as the biopsy device trigger releases. You may feel a brief pressure sensation, but this should not be painful. This process will be repeated another 2–3 times in order to collect sufficient amount of tissue for analysis.
Once samples have been collected, a small dressing will be placed over the biopsy area.
After your procedure
You will be transferred to the Stella Maria ward, Allevia Hospital to recover. The nurses will monitor your recovery and if appropriate, you will usually be discharged after 4 hours, or you may need to stay overnight.
The liver comprises of many blood vessels which means that there is a risk of bleeding after the procedure. Because of this, it is important that:
- You will need to remain flat or in the position the interventional radiologist placed you in for the procedure for 2 hours.
- You will then be able to sit up slowly for the following 2 hours, as directed by your nurse. This allows the small nick in the liver to heal.
You may experience shoulder tip pain after the biopsy. Please inform your nurse, and medication to help relieve the pain can be given. This pain occurs in some people due to the irritation of the phrenic nerve caused by the biopsy needle. This pain should subside before you are discharged.
Recovery and discharge
- Following your procedure, it is important that you do not drive for 24 hours.
- Please ensure you have a family member or friend to drive you home from the hospital, as you may still be under the effects of anaesthesia or sedation.
- You will need to arrange someone to be at home with you on the day of your discharge and overnight to support you in your recovery.
- Due to the sedation, you may feel lethargic afterwards with reduced concentration. For this reason, for 24 hours after your procedure:
- Do not do any activity requiring strength, concentration, or full alertness.
- Do not make any legal decisions or sign legal documents.
Resuming activities
- You will be able to return to work within a week of having the procedure unless your job involves heavy lifting (>5kg).
- You can begin light exercise after 1 week.
Medication
Procedure site care
There will be small dressing over the access site. This may be removed when you have a shower the day after the procedure.
You must go to your local emergency department immediately if you start to experience the following:
- Increased abdominal pain despite analgesia.
- Feeling faint.
- Bleeding from the puncture site.
It is vital you explain to the emergency department health professional that you have had a liver biopsy.
Seek immediate medical attention (dial 111 for an ambulance) if there is excessive bleeding from the puncture site or if you are experiencing severe chest pain.
- If you have any concerns, please contact IntraCare:
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- Monday to Friday (6:30am – 6:00pm): 09 630 1961
- After-hours, weekends, and public holidays: 0274 820 763
In case of emergency, always call 111.