LIVER BIOPSY IN INDIA

LIVER BIOPSY

Biopsy is a procedure in which a small tissue from any organ or lump in the body is taken to be examined under a microscope. Biopsy is the most definitiive test for any kind of disease. If a person is diagnosed to have any kind of liver dieases through blood tests or imaging tests like Ultrasound, CT Scan or MRI then Liver Biopsy might be required to confirm the diagnosis. Liver Biopsy is also done to gauge the extent of the disease specially in cases of Liver Cirrhosis.

The most common type of liver biopsy is called percutaneous liver biopsy. It involves inserting a thin needle through your abdomen into the liver and removing a small piece of tissue. Two other types of liver biopsy one using a vein in the neck (transjugular) and the other using a small abdominal incision (laparoscopic) also remove liver tissue with a needle.

A liver biopsy is commonly performed to help diagnose and stage certain liver diseases, including:

Non-alcoholic fatty liver disease

Chronic hepatitis B or C

Autoimmune hepatitis

Alcoholic liver disease

Primary biliary cirrhosis

Primary sclerosing cholangitis

Hemochromatosis

Wilson's disease

RISKS

Liver Biopsy has some risks associated with it if not done carefully. It is due to this reason that non invasive diagnostic tests like Liver Elastography on Ultrasound / CT / MRI are gaining more importance than biopsy. The risks associated with liver biopsy are :

Pain - Pain at the biopsy site is the most common complication after a liver biopsy.

Bleeding - Excessive bleeding may require you to be hospitalized for a blood transfusion or surgery to stop the bleeding.

Infection - Sometimes bacteria may enter the abdominal cavity or bloodstream while doing liver biopsy.

Accidental injury to a nearby organ. The needle may stick another internal organ like gall bladder or lung during biopsy.

In a transjugular procedure, a thin tube is inserted through a large vein in your neck and passed down into the vein that runs through your liver. If you have a transjugular liver biopsy the risks include:

Hematoma Collection of blood in the neck.

Facial Nerves - Short term problem like drooping eyelids if any facial nerve gets injured.

Voice problems - You may be hoarse, have a weak voice or lose your voice for a short time.

Lung Puncture - If the needle accidentally sticks your lung, the result may be a collapsed lung (pneumothorax).

PROCEDURE

Liver Biopsy can be done under local anaesthesia or general anaesthesia. You would be asked to come to the hospital in fasting status for 6-8 hours.

Percutaneous biopsy is normally done under the guidance of ultrasound or CT Scan and the procedure takes not more than 15 minutes. A small incision is made under the rib cage which does not require any stiches after the procedure.

Transjugular biopsy is done under C-Arm in the operation theatre. A small incision is made in the neck region after applying local anaesthesia. A thin flexible tube is inserted through the jugular vein in the neck and pushed to the hepatic vein in the liver. Contrast dye is injected through the plastic tube and x-rays are taken. A biopsy needle is then inserted through the flexible tube and samples from the liver are taken.

Laparoscopic biopsy - You'll be positioned on your back on an operating table and your doctor will make one or more small incisions in your abdomen. Special tools are inserted through the incisions, including a tiny video camera that projects images on a monitor in the operating room. The doctor uses the video images to guide the tools to the liver to remove tissue samples. The incisions are closed by stitches.

If the procedure is done under local anaesthesia, you can go home within 3-4 hours of the procedure. However if general anaesthesia is given then you might have to stay overnight in the hospital.

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