The liver is a very large organ in the right upper abdomen.
In fact, most of the liver lies behind the ribs in the right-lower chest.
The liver is remarkable, quietly making many proteins, eliminating waste
products, and participating in the general metabolism and nutrition of
the body. There are many different problems that can occur in the liver.
These include virus infections, reactions to drugs or alcohol, tumors,,
hereditary conditions, and problems with the body's immune system.
The Evaluation of a Chronic Liver Condition
The physician will always take a medical history and perform
a physical exam. Blood studies, known as liver function tests (LFT), give
an overview of the health of the liver. If LFT results are persistently
abnormal, the physician will then perform additional medical studies to
determine the exact cause of the problem. This is particularly important
because there are now effective treatments for many chronic liver disorders.
Finally, the physician will want to know not only the specific cause of
the problem, but also the severity of it. The liver biopsy helps answer
The Benefits of a Biopsy
A biopsy is a small sample of body tissue. This tissue
is prepared and stained in a laboratory. The physician can then view it
under a microscope. By so doing, he or she can often make a specific diagnosis
and determine the extent and seriousness of the liver disease. This information
is often vital in determining the treatment.
The liver biopsy is usually performed on an outpatient
basis in the radiology department at the hospital. At times, an ultrasound
or echo machine is used to identify the best location to make the biopsy.
Usually, the physician can make this determination simply by examination.
The patient lies quietly on the back or slightly to the left side. In
some instances, the patient will be given some mild sedation at this point.
The physician usually reaches the liver through the lower-right chest
between the ribs. That area is first carefully cleaned. A local anesthetic
agent like Novocain is used to numb the skin and tissue below. A specially
designed thin needle is inserted through the skin. At this point, the
physician will tell the patient how to breathe. The needle is quickly
advanced into and out of the liver, taking only 1 or 2 seconds. This should
not hurt due to the local anesthetic given to you. A slender core of tissue
is thereby obtained which is then processed through the laboratory. The
entire procedure from start to finish lasts only 15 to 20 minutes.
The patient is kept at rest for several hours following
the exam. Medical personnel check the heart rate and blood pressure. At
times, there is some discomfort in the chest or shoulder after the anesthetic
wears off. This is usually temporary and medication is available if needed.
The patient is given instructions regarding activity and eating before
being discharged home. Activity is usually restricted for a day or so
In most instances, a liver biopsy is obtained quickly
with no problems. As noted, there is occasionally some fleeting discomfort
in the right side or shoulder. Internal bleeding can sometimes occur,
as can a leak of bile from the liver or gallbladder. These problems are
usually handled conservatively without the need for surgery.
A liver biopsy
is a simple, rapid method of obtaining a sample of liver for analysis.
This information is of great importance in guiding the physician in his
or her evaluation and treatment. While some complications can occur, they
are unusual. The benefits of the exam always outweigh the risk. With this
biopsy information, effective and specific therapy can usually be provided
to the patient.