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Medical Author:

David C. Wolf, M.D., FACP, FACG, AGAF

Medical Editor:

Jay W. Marks, MD

Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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Below, we describe the procedure for ultrasound-guided percutaneous liver biopsy at a typical hospital. It is provided to give patients a sense of what to expect. Not all hospitals or institutions follow the same protocol for procedures.

• Arrive at ambulatory surgery.
• Undergo placement of an intravenous line.
• Go to interventional radiology and meet with the interventional radiologist who will do the procedure.
• Review the reasons for, benefits, risks and alternatives of biopsy with this physician.
• Sign an "informed consent" form to give permission for the procedure to be performed.
• Receive an intravenous sedative medication (this is optional).
• Undergo an ultrasound to identify the ideal site for biopsy.
• The skin over the biopsy site is cleansed.
• A small volume of a local anesthetic is injected in a sterile fashion into the biopsy site.
• A small (~ 5-10 mm long) incision is made in the skin.
• The liver biopsy needle is positioned correctly and the biopsy is performed.
• The patient is transported back to the recovery room.
• The patient awakens.
• The patient is asked to remain still in bed for another 2 to 5 hours.
• Heart rate and blood pressure are monitored by the recovery room nurse.
• Pain medicines are administered, as needed.

Infrequently:

• Check a blood test or order an imaging study to rule out post-biopsy bleeding.
• Infuse intravenous fluids.
• The patient is discharged home.

Unless otherwise stated, patients must avoid aspirin and nonsteroidal anti-inflammatory drugs (for example, ibuprofen) for at least one week after biopsy. The patient is instructed to call the physician immediately in the event that he or she experiences, chest pain, abdominal pain, dizziness, or shortness of breath.

The patient returns for follow-up in the physician's office one week later to assess his or her post-biopsy symptoms (if any) and review the biopsy results.

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