Liver biopsy is a medical procedure necessary to obtain a small sample of liver tissue for direct examination under a microscope. While blood tests and clinical observations give enough information, liver biopsy provides a much higher level of certainty to clinical decision making in people with liver disease.

The information supplied by liver biopsy can be summarized in the following points:

Liver biopsy is a routine procedure in low risk in experienced hands.

• Diagnosis: biopsy provides information important to confirm the diagnosis. Today, with the large amount of blood diagnostic tests, often the cause of liver disease has been determined before reaching the biopsy, but it remains the method of confirmation.
• Forecast: This is probably the most relevant information delivery liver biopsy, and may be divided into:
• Fibrosis: Chronic liver disease often shows a progression from normal to marked fibrosis (equivalent to liver cirrhosis). The biopsy can know at what stage of the disease the patient, allowing decisions about treatment is.
• Level of activity: The liver biopsy can determine the degree of liver inflammation that has chronic hepatitis (hepatitis C), indicating to some extent the rate of progression with the disease.

Liver biopsy may be performed in outpatient settings or can recommend a short hospital stay (one night). The patient should come fasting. Usually locates the best place to puncture through the right side percussion or ultrasound (ultrasound). Once located the site, infiltrate the skin with a local anesthetic and a needle is inserted you get a small piece of liver. The procedure itself takes less than 1 second.

Liver biopsy is a routine procedure in experienced hands has a very low risk of complications. The most important complication is bleeding, which occurs in less than 1% of cases. Is seen most often in people with blood clotting problems and people with cancer. Other less common complications include puncture of other organs (gallbladder, kidney, etc.) And infection. Any of these complications may require a procedure (including surgery) to solve the problem; however this is something extremely rare. To reduce the risk of bleeding is recommended that patients stop taking aspirin or other anti-inflammatory during the week before the procedure.

You may feel mild to moderate pain after the procedure, both on the right side as on the right shoulder, which is managed with analgesics.

There are alternatives to percutaneous liver biopsy:

Tran jugular liver biopsy via: Through a catheter inserted through the right jugular vein access the hepatic vein and a sample of liver tissue. This route has the advantage of having a lower risk of bleeding, which is especially useful in patients with significant alterations in coagulation. The disadvantage is that tissue samples are smaller, so that the interpretation of their results is more difficult.

Laparoscopic liver biopsy: By laparoscopy can explore the surface of the liver and a sample of liver tissue. This procedure has the advantage of being more confident to perform homeostasis directly at the puncture site and in addition to visualizing the surface of the liver, which rapidly in the diagnosis of cirrhosis and other conditions.

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