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What is a liver biopsy? A liver biopsy is a procedure used to obtain a small sample of liver tissue. This sample is later examined closely to determine the extent of liver damage, if any, and can be very useful to diagnose certain conditions of the liver such as HCV, cirrhosis, or liver cancer. If you are diagnosed with HCV without a liver biopsy (based on a blood test, see above), your doctor may recommend a liver biopsy prior to initiating treatment with interferon. The reason for this is that a liver biopsy will provide a starting point, or baseline, of how the liver is damaged. After interferon therapy is complete, another biopsy may be performed to see if there is improvement in the liver tissue. In effect, it allows the patient and the doctor to know if treatment is working.

To prepare yourself for the procedure, be sure to tell your doctor all the medications you are currently taking. Some medications may interfere with normal clotting of blood, so it is important that your practitioner is aware of every medication you take, including over the counter and herbal remedies. Furthermore, be sure to tell your doctor if you are pregnant or have any drug allergies.

Prior to the procedure, you may have blood-work performed to check how well your blood clots. This will ensure that you are be able to heal appropriately following the biopsy. You will also be asked to sign a consent form that states you understand the risks of the procedure and are giving the doctor permission to perform it.

The actual biopsy is typically performed in a hospital, and should be done by a skilled physician, usually a hepatologist (see hepatologist). During the procedure, you will be laying on your back. You will first be given a medication to sedate you and then a local anesthetic. A general anesthetic is typically not used because it is important that all pain sensation is NOT blocked. This is so the patient can report pain---an indicator to the doctor that the needle may not be in the right place (the liver). After the sedative and pain medication is administered, the doctor will make a small incision in the abdominal area where the liver is located. The biopsy needle will then be inserted into the incision and a sample of tissue will be removed quickly. You will feel some pressure and dull pain when this occurs. After removing the needle, the doctor will apply firm pressure to the incision site to stop any bleeding.

Although hepatologists are highly skilled in performing liver biopsies, there are risks associated with them, just like every invasive procedure. The most common risks associated with a liver biopsy include internal bleeding, and injury to internal organs by the needle (for example, a collapsed lung). Your doctor will do everything to minimize all risks possible. Since you are awake during the procedure, it is essential that you communicate any extreme pain or unusual sensations that you are experiencing.

Once the procedure is complete, you may feel some residual pain. This can be treated with medications prescribed by your doctor. Any pain typically lasts no more than a couple days, and gets better each day.

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