Percutaneous liver biopsy
Information for patients from the Radiology Department
You have been referred for a percutaneous liver biopsy. This leaflet explains:
what a percutaneous liver biopsy is
what to expect when you come to the hospital for your biopsy, and
the possible risks to having the procedure.
A liver biopsy is usually planned well in advance. If you have any questions or concerns, speak with one of your own doctors or the person that is performing the biopsy.
Make sure that you understand what is involved before you sign the consent form. Remember, you can change your mind at any time.
What is a percutaneous liver biopsy?
Percutaneous means “through the skin”.
The liver sits on the right side of your upper abdomen.
A liver biopsy is where a small piece of tissue from the liver is removed, using a special needle.
Why do I need a liver biopsy?
Scans have shown you have an abnormality in your liver. These scans do not always show the cause or the severity of these abnormalities. Sometimes we need to look at a sample of your liver under a microscope, to help with your diagnosis.
Who has made this decision?
The consultant in charge of your care and the radiologist performing the biopsy will have discussed your care. They have decided that a biopsy is the best way of making a diagnosis and planning your treatment.
Your opinion will always be considered. If after talking to your doctors you do not want to have the procedure, you can decide against it.
Who will be performing the biopsy? Where will the biopsy take place?
A specially trained doctor, called a radiologist, will perform the biopsy. They will use imaging equipment, usually an ultrasound, to place the biopsy needle accurately into your liver.
Generally, the procedure takes place in the X-ray Department, in one of the scanning rooms. The x-ray staff will make you as comfortable as possible.
What happens before my procedure?
Before your biopsy you will have blood tests to make sure your blood clots properly. Please make sure you tell staff about any mediation you take, especially those that affect blood clotting, such as aspirin or blood thinners.
You may not be able to eat or drink anything for a few hours before your biopsy. Your doctor will tell you whether you can take your regular medications during this time. They may also give you other special instructions.
Before the procedure, the radiologist will discuss the steps of the procedure and potential complications. They will also ask you to sign a consent form, to confirm that you are happy to proceed with the biopsy.
Why do I need to sign a consent form?
All patients must give permission before they receive any type of medical treatment, test, or examination. Consent is usually given when you sign the consent form before your treatment, but we may ask you to give it verbally.
You must give your consent voluntarily.
The hospital must give you all the information you need to make a decision about your treatment. This is so you can give us informed consent. If you have not been given this information, or you have but you still have questions, please speak to a member of staff.
You must be capable of giving consent. This means that you understand the information given to you and can make an informed decision.
When we ask you to give consent, please use this time to ask any questions you may still have. More information is available on the NHS Consent for Treatment web page. Remember, you can withdraw your consent for treatment at any time.
What happens during the liver biopsy?
In the scan room, you will lie on your back on a hospital bed with your hand above your head.
Before the biopsy begins, the radiologist will clean your skin with antiseptic to avoid infection.
The radiologist will scan your liver to find the best place to do the biopsy.
Your skin and deeper tissues are injected with local anaesthetic. This will briefly sting, before the area goes numb.
The radiologist will make a small cut, and insert the biopsy needle to take a sample of your liver tissues. The radiologist may use an ultrasound scan to guide the needle to the exact position for a biopsy.
If you have an increased risk of bleeding, the radiologist may place a small metal coil into the needle puncture site. This looks like a spring and causes blood to clot around it, stopping any bleeding.
How long will it take?
The whole procedure takes between 15 to 20 minutes, as positioning the biopsy can take a little time. The biopsy itself takes only a few seconds.
Will it hurt?
You will feel stinging as the local anaesthetic is injected. You will also feel pressure on your skin as the radiologist places the biopsy needle. Some people also feel some discomfort as the needle enters their liver.
You may feel discomfort in your right shoulder or stomach after the biopsy. This is common and you will be offered painkillers. Let the nursing staff know if the discomfort does not go away.
What happens after the procedure?
After your biopsy, you will be asked to stay lying flat for several hours. During this time the nursing staff will take your pulse and blood pressure regularly. All being well, you can go home either on the same day or the next morning.
When will I get the results of my biopsy?
The results of your biopsy will not be available immediately. It takes 2 to 4 weeks to do all the necessary tests on the biopsy specimen.
What are the risks and complications?
Percutaneous liver biopsy is generally a very safe procedure, but some risks and complications can still arise.
The most common complication is pain after the procedure, which may take several hours to settle.
Bleeding is usually minimal, and does not last long.
More serious bleeding can happen. You may develop a large bruise either in or around your liver or a leakage of blood into your abdomen or gut. If the bleeding is serious, you may need another radiological procedure or an operation.
Is there an alternative test?
There is no radiological alternative test.
Further information
Hopefully, this leaflet will have answered some of your questions. If you still have questions or concerns, please speak to the doctors looking after you. Make sure that you understand the procedure and its risks before you sign the consent form.
You can also contact the Radiology nurses on:
Kent and Canterbury Hospital, Canterbury
Telephone: 01227 766877 extension 722-5037Queen Elizabeth the Queen Mother (QEQM) Hospital, Margate
Telephone: 01843 225544 extension 725-3271William Harvey Hospital, Ashford
Telephone: 01233 633331 extension 723-8930