What is Biopsy of Liver

Biopsy of Liver

A biopsy of liver is a course of action to extract a small piece from the liver to examine the symptoms of further damage or disease and this process has been done with a microscope observation.

  • removes toxic substances from the blood

  • helps to fight against infections

  • helps digestion of food

  • stores essential nutrients and multivitamins

  • reserve store of energy

A liver biopsy is usually performed when problems in liver cannot be diagnosed only with blood tests or techniques used to take liver images for study such as ultrasound techniques and x rays.

It is very useful in the diagnosis of diseases that affect the liver function.

Mostly, a liver biopsy is performed to guess the degree of damage to the liver. This process which helps to study is called staging. Staging helps as a guide for the treatment.

History of Biopsy of Liver

In 1883, liver aspirate was firstly made by Paul Ehrlich, a German physician. In 1920, reports suggest the performance of first percutaneous liver biopsy.

A revolution came in the invention of the liver biopsy in 1958, when Menghini developed a procedure called as “one second needle biopsy of the liver”.

Purpose of Biopsy of Liver

The biopsy helps diagnose many liver diseases. The procedure also helps assess the stage (early, advanced) of liver disease. This is especially important in hepatitis C infection.

Biopsy is used to Detect

  • Diseases like cirrhosis, hepatitis and cancer

  • Infections  such as tuberculosis

  • Cause of abnormal values of liver enzymes found after the blood tests

  •  Undetermined cause for enlargement of liver

  • Amoebic liver abscess

  • Autoimmune hepatitis

  • Biliary atresia

  • Hepatitis B

  • Hepatitis C

  • Chronic active hepatitis

  • Chronic persistent hepatitis

  • Disseminated coccidioidomycosis

  •  Hemochromatosis

  • Hepatitis D

  • Hepatocellular carcinoma

  • Hodgkin's lymphoma

  • Nonalcoholic steatohepatitis

  • Non-alcoholic fatty liver disease

  • Non-Hodgkin's lymphoma

  • Primary biliary cirrhosis

  •  Pyogenic liver abscess

  • Reye syndrome

  • Primary Sclerosing cholangitis

  • Wilson's disease

Diagnosis of the Disease

A liver biopsy is important and useful test to diagnose several diseases that influence the liver and bile ducts. A small piece or pieces of tissue are detached from the liver and given for the examination. Biopsy is now used as a diagnostic technique for many diseases associated with liver.

Monitoring of Chronic Diseases

A liver biopsy can be a useful tool for the doctor to monitor the efficiency of therapy given to the patient for the diseases in which the liver gets affected. Similarly, it can provide a warning for certain therapies; a patient is undergoing and shows the side effects causing damage to the liver.

Types of Biopsy of Liver

The main types of liver biopsy procedures are percutaneous, percutaneous image guided, laparoscopic and open surgical liver biopsy.

Percutaneous Liver Biopsy

In a percutaneous liver biopsy procedure, local anesthesia is given to the numb the skin of the patient and a small incision is made.  It uses a needle with the diameter of a pen refill and the needle is then passed through the skin and goes into the liver and a sample is detached. Multiple biopsies can be done depending on the severity of the disorder

Percutaneous Image-Guided Liver Biopsy

A percutaneous image-guided liver biopsy almost resembles to the one explained above except that the needle insertion is guided by using CT scan or ultrasound images. This is many times helpful when the disease course is localized to isolated spots in the structure of the liver.

Laparoscopic Liver Biopsy

A laparoscopic liver biopsy can be done exclusively for the intention of receiving the biopsy specimen or can involve as a part of other operative procedure. Small cuts are made in the abdomen of the body and instruments are put in through surgical trocars and the biopsy specimen is obtained. The instrument laparoscope is a telescope that enlarges the substances it sees and facilitates excellent revelation of the surface of the liver.  Along with laparoscopic biopsy, ultrasound technique can also be used in this procedure.

Open Surgical Liver Biopsy

Open liver biopsies are very rarely performed procedures nowadays unless they are required along with the other operative procedures. In an open biopsy, the surgeon has a choice to make to choose and use a biopsy needle or surgically cut a small wedge of tissue of the liver.

More About Biopsy of Liver Surgery