Liver biopsy

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Microfoto of a liver biopsy showing liver metastasis . HE staining .

A liver biopsy is a removal of tissue from the liver . It is a medical examination method used to examine diffuse or circumscribed liver changes.

Types of liver biopsy

  • sonographically guided liver biopsy
    • untargeted
    • targeted from a liver focus
  • laparoscopic liver biopsy
  • CT guided liver puncture
  • intraoperative liver biopsy
  • Liver blind puncture
  • transjugular liver biopsy

Liver biopsy procedure

In the currently most frequently performed sonographically guided liver biopsy, the patient is first examined using ultrasound and the puncture site is determined. The skin is thoroughly disinfected. The patient then receives sedation (e.g. with midazolam ) and local anesthesia in the area of ​​the puncture site. The puncture cannula is then prepared and the punch cylinder removed. The punch cylinder is placed in a preservation solution and sent to the pathologist. There the tissue is embedded in paraffin, cut into thin sections, colored and examined using a microscope. The findings are returned to the examiner (usually within 1–2 days).

After the puncture, the patient remains under observation by the doctor for a few hours and then receives an ultrasound examination so that any secondary bleeding can be detected promptly.

When do you do a liver biopsy?

  • Diffuse liver diseases that cannot be diagnosed otherwise.
  • For lumps in the liver that cannot be diagnosed otherwise.
  • If hemochromatosis is suspected , if the previous genetic test is without results.
  • To rule out acute rejection after orthotopic liver transplantation

Possible complications

In the hands of an experienced examiner, the liver puncture is a largely safe medical measure with normal coagulation conditions . With sufficient sedation and local anesthesia, it is hardly stressful for the patient. After performing the liver biopsy, many patients still feel pressure in the area of ​​the puncture site for a few hours to a few days. The liver puncture cannot be performed if the liver is infected with echinococcus ( tapeworm ) and in some other rare contraindications . Organs that the liver biopsy can accidentally injure: the lungs , intestines, or gallbladder . The complication rate for an experienced examiner is less than 1%. A slight rebleeding into the abdominal cavity is usually without consequence. The patient must be informed about the purpose of the liver biopsy and possible complications before the examination.

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