Liver biopsy

What to expect when having a liver biopsy and why they are used in PSC

A liver biopsy is an invasive procedure that takes very small samples of liver tissue for investigation (about 1/50,000th of your liver).

It is used to look at damage to the liver, but not used for diagnosis of PSC unless small duct PSC or another autoimmune liver disease is suspected. Because of the information it can give, and the lack of non-invasive tests to measure progression in PSC, liver biopsy is a valuable test in PSC research studies and clinical trials.

What happens during a biopsy?

You will be asked not to eat anything for at least 4 to 6 hours before you have your biopsy.

  1. For the procedure, you will be asked to lie on your back and a small area of your RUQ will be numbed. A biopsy needle is then inserted through your abdominal wall. Ultrasound is used to guide the needle to the correct place.
  2. For some biopsies, the needle is inserted through your neck (transjugular biopsy) and the needle is guided by x-ray.
  3. You will often be told to hold your breath while the biopsies are taken. You may be aware of a feeling like pinching deep inside you when the biopsies are taken.
  4. Once the biopsy needle is removed pressure is applied to stop any bleeding. The samples are then sent off to the laboratory for examination.
  5. After the biopsy, you have to lie still for four to six hours. You will be monitored during this time. In most cases, you will be seen as a day case. Occasionally you will be kept overnight.

Does a liver biopsy hurt?

You may experience some discomfort or pain. If you feel nervous about having a biopsy, talk to your doctor well in advance of the procedure so that sedation can be arranged. Women sometimes find that they are unable to wear a bra immediately afterwards but might find a crop type top useful for support.

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