(Biopsy-Liver, Percutaneous Liver Biopsy)

Procedure Overview

What is a liver biopsy?

A liver biopsy is a procedure in which tissue samples from the liver are removed for examination under a microscope to look for signs of damage or disease. It is used to diagnose many liver conditions. During a liver biopsy, tissue samples are removed with a special needle to determine if cancer or other abnormal cells are present, or to determine how well the liver is working.

There are three types of liver biopsies:

  • percutaneous or needle biopsy - After a local anesthetic is given, the physician inserts the special biopsy needle into the liver to obtain a sample. Ultrasonography or fluoroscopy (a type of x-ray "movie") may be used to guide the biopsy needle insertion. Most liver biopsies are performed using this technique.

  • laparoscopic or open biopsy - After a general anesthetic is given, the physician makes an incision in the skin and surgically removes a piece of the liver. Depending upon the lab findings, further surgery may be performed.

  • transvenous biopsy - After a local anesthetic is given, the physician makes an incision into a vein on one side of the neck and inserts a specially designed hollow tube called a sheath through the vein down to the liver. One or more tissue samples are removed through the tube.

If your physician wants to sample a specific area of the liver, the biopsy may be performed in the radiology department, guided by ultrasound (high-frequency sound waves), magnetic resonance imaging (MRI, a combination of large magnets, radiofrequencies, and a computer), or computed tomography (CT scan, a combination of x-rays and computer technology).

Other related procedures that may be used to diagnose liver problems include abdominal x-rays, CT scan of the liver, liver scan, and abdominal ultrasound. Please see these procedures for additional information.

Anatomy of the liver:

The liver is the largest organ in the body. It is located in the upper right side of the abdomen, beneath the diaphragm, and on top of the stomach, right kidney, and intestines. Shaped like a cone, the liver is a dark reddish-brown organ.

The liver holds about one pint (13 percent) of the body's blood supply at any given moment. The liver consists of two main lobes, each made up of thousands of lobules. These lobules are connected to small ducts that connect with larger ducts to ultimately form the hepatic duct. The hepatic duct transports the bile (fluid that helps break down fats and gets rid of wastes in the body) produced by the liver cells to the gallbladder and duodenum (the first part of the small intestine).

The liver carries out many important functions, such as:

  • making bile - fluid that helps break down fats and gets rid of wastes in the body

  • changing food into energy

  • clearing the blood of drugs and other poisonous substances

  • producing certain proteins for blood plasma

  • regulating blood clotting

  • storing vitamins and other nutrients

  • fighting infection

Reasons for the Procedure

A liver biopsy is useful to diagnose conditions of the liver that cannot be determined by symptoms or lab tests. When a person has an enlarged liver, jaundice (yellowing of the skin and eyes due to bile pigments in the blood), or abnormal lab tests that suggest liver disease, a biopsy may be done.

A liver biopsy may be performed to diagnose:

  • hepatitis - inflammation of the liver that sometimes causes permanent damage, resulting from viruses, drugs, alcohol, or parasites

  • alcoholic liver disease

  • liver tumor - an abnormal lump or mass of tissue. Tumors can be benign (non-cancerous) or malignant (cancerous).

  • fatty liver - buildup of fat in liver cells

  • fibrosis of the liver - the growth of scar tissue due to infection, inflammation, injury, or even healing

There may be other reasons for your physician to recommend a liver biopsy.


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