This information is approved and/or reviewed by U-M Health System providers but it is not a tool for self-diagnosis or a substitute for medical treatment. You should speak to your physician or make an appointment to be seen if you have questions or concerns about this information or your medical condition.| Complete disclaimer
What is a liver biopsy and how is it done?
A liver biopsy is a diagnostic procedure, performed by the physicians of the Gastroenterology Division of Internal Medicine. Occasionally, liver biopsy is performed by physicians in Radiology also. A liver biopsy is done to obtain liver tissue which can help determine the extent and cause of liver injury.
A liver biopsy is the removal, with a needle, of a small sample of liver tissue which can be examined under the microscope. You will lie on your back for the biopsy. A local anesthetic (numbing medicine) will be given at the site of the biopsy before the needle is inserted. Pressure may be felt but pain should be minimal. After the biopsy you may feel mild to moderate pain or soreness at the biopsy site, your right shoulder, or upper abdomen; if this occurs you will be offered a pain medicine in the recovery area.
What are the potential complications of a liver biopsy?
A liver biopsy is generally a safe procedure. As with any medical procedure, however, there are risks with the procedure.
Complications associated with a liver biopsy range from minor to significant. Minor complications may include pain or discomfort at the biopsy site or in the right shoulder or upper abdomen. Significant complications are rare, but they can and do occur. Significant complications include inadvertent puncture of the lung, gallbladder, or bowel, infection, severe bleeding and pain. Surgery may be required to correct the situation. Most cases of bleeding stop without treatment or can be controlled at or shortly after the time of the procedure; rarely, blood transfusions or other treatments may be required to treat the bleeding. There may be other risks depending upon your specific medical condition (e.g., if you are pregnant or if you have a condition that affects the blood’s ability to clot). Be sure to discuss any concerns with your physician prior to the procedure.
Although complications after a liver biopsy are rare, they can be serious and life-threatening. It is important for you to be aware of early signs that something might be wrong. You should contact your doctor if you feel severe abdominal pain, fever, lightheadedness, persistent vomiting, vomiting of blood, severe shoulder pain, chest pain, shortness of breath, or redness, swelling, red streaking or pain at your intravenous injection site.
Why is a liver biopsy necessary?
A liver biopsy is done to obtain tissue which can help determine if there has been injury to the liver, the degree of injury and its cause.
How do I prepare for my test?
Preparation for the biopsy takes about 10 minutes. The biopsy itself will take less than a minute although you will likely be in the procedure room for about 20 minutes. Patients do not routinely receive sedation for liver biopsies; please discuss this with your doctor in advance. Your skin will be numbed with a local anesthetic. You will stay in the recovery room for at least 2 hours and up to 4 hours after your biopsy so that you can be observed for any bleeding, pain, or signs of other complications.
There are some important things you should do to prepare for your biopsy.
You may have a light or liquid breakfast the morning of the biopsy.
If you take oral diabetes medicine (pills): Do not take the medicine the morning of your test. Bring your diabetes medicine with you.
- If you have diabetes and take insulin, you should request an early morning appointment. Take only one-half of your usual dose of NPH, Lente or Novolin 70/30 insulin and no regular insulin the morning of your test. If you also take insulin the evening before your test, take one-half of your usual dose of NPH, Lente or Novolin 70/30 insulin and no regular insulin (you may have only clear liquids for lunch and dinner the day of your liver biopsy). Please review the handout, "Instructions for Patients with Diabetes Having Outpatient Procedures/Tests," which the ordering physician will provide. The handout may be found on the web at following web address: www.med.umich.edu/1libr/aha/umdiabetesinsulin.htm
You must also inform the nurse at time of scheduling if you are taking anti-arthritic medicine, non-steroidal anti-inflammatory drugs (NSAID), aspirin, anti-platelet agents (like plavix) or blood thinner medicine such as Coumadin, thrombin inhibitor or heparin. If a physician ordered one (1) of these drugs, be sure to contact the doctor that ordered the drug before stopping the medicine. Within one week, seven (7) days, of your test do not take aspirin, NSAID drugs, anti-platelet agents, or blood thinners as they can increase bleeding. A few commonly known products you should avoid include:
The day of the procedure
Your procedure is scheduled for
If you are unable to keep your appointment, please call the Medical Procedures Unit at 734-936-9250 # 1 as soon as possible.
The procedure will be performed on the main campus of the U-M Medical Center or at the East Ann Arbor Ambulatory Surgery site. If your procedure is scheduled on the main campus, go to the Medical Procedures Unit, University Hospital, Level 2, Room 2B 353.
You may have a light or liquid breakfast the morning of your test. You should take your heart and blood pressure medicines before leaving home.
Please bring the following when you come for your liver biopsy:
A list of all medicines you are taking
A list of your allergies
Health Insurance Cards
A responsible adult (18 years old or older) to stay with you during your visit. The procedure will be started when your adult driver is present. You may not drive for at least 12 hours. You will not be discharged from the hospital until your driver is present to pick you up.
You may wish to bring reading materials or music with a head set.
Please leave jewelry and valuables at home.
Small children will be more comfortable at home.
It is very important that you bring a responsible adult driver with you to drive you home. No activity is permitted the same day as the biopsy.
After the Procedure:
- You will not be able to drive a car or return to work until the following day after your procedure.
- You may resume normal activity, including travel and flying in seven (7) days.
- You should not lift anything heavier than ten (10) pounds for seven (7) days.
- You should contact your doctor if you feel something is wrong, especially if you feel severe abdominal pain, fever, lightheadedness, persistent vomiting, vomiting of blood, severe shoulder pain, chest pain, shortness of breath, or redness, swelling, red streaking or pain at your intravenous injection site.
Our goal in the Gastroenterology Division is to provide high-quality medical care to all of our patients. If you have additional questions, or if you would like to schedule or reschedule an appointment, please call us at 734-936-9250 between 8:00 a.m. and 5:00 p.m., Monday through Friday.
Updated 2011, Fran Shultz, Medical Procedures Unit
U-M Health System Related Sites:
University of Michigan Comprehensive Cancer Center
Department of Internal Medicine Division of Gastroenterology