Liver biopsy

What is a liver biopsy?

A liver biopsy is the removal of a tissue sample from the liver. Synonymously for a liver biopsy, liver puncture is also used. It is performed to determine the cause of unclear liver disease or to monitor the course of chronic liver disease.

Indications for a liver biopsy

The indication for a liver biopsy is determined by the treating physician. He will carefully weigh the benefits of a liver biopsy against the possible risks. Possible indications for a liver biopsy may be

  • The clarification of liver values deviating from the norm (elevated liver values)
  • Chronic liver diseases
  • Inflammatory liver diseases
  • The suspicion of cancer
  • An unexplained jaundice
  • Metabolic diseases
  • A fatty liver.

Is a liver biopsy painful?

A liver biopsy is less painful due to the local anesthesia of the skin and muscles in the area of the puncture site. Nevertheless, slight pain may sometimes occur during the procedure. This can radiate into the shoulder. If pain occurs, painkillers can be administered.

What is the pain after a liver biopsy?

After a liver biopsy a slight and dull pain may occur. This may also radiate into the shoulder. Painkillers such as paracetamol can be taken if necessary. Aspirin and ibuprofen should not be taken after a liver biopsy because they have an inhibitory effect on blood clotting. If very severe pain occurs, a doctor should be consulted immediately to rule out possible complications.

Preparation before a liver biopsy

Before a liver biopsy, anticoagulant drugs should be partially discontinued. The anticoagulant drugs include Marcumar, new oral anticoagulants (NOAK), ASS, Clopidogrel, but also some painkillers (NSAIDs) such as Ibuprofen. The interval at which the medication must be discontinued and which ones you can continue to take should be discussed with your treating physician.

Even after the liver biopsy, the medication that has been discontinued should not be taken for a few days to reduce the risk of secondary bleeding. Before a liver biopsy is performed, you will have an informative talk in which you will be informed about the procedure, possible risks and, if necessary, alternative procedures. On this day, blood is usually taken again to determine the current blood values.

The blood count and the current coagulation values are of particular importance here. You should be fasting on the day of the liver biopsy. This means that the last meal can be taken the evening before the liver biopsy.

Clear liquids such as water or tea may usually be drunk in moderation up to 4 hours before the biopsy. Here too, it is advisable to consult the treating physician. The medications that you normally take on the day of the liver biopsy in the morning and at noon should generally only be taken after the liver biopsy. However, your treating physician will also inform you about this.