Biópsia of the liver: what is it for, like é made and recoverção

2023 Author: Benjamin Dyson | [email protected]. Last modified: 2023-05-21 01:37

A liver biopsy is a medical examination in which a small piece of the liver is removed, to be analyzed under a microscope by the pathologist, and thus, diagnose or evaluate diseases that are harming this organ, such as hepatitis, cirrhosis, systemic diseases that affect the liver, or even cancer.

This procedure, also called a liver biopsy, is performed in the hospital, as the sample is taken from the liver with a special needle, in a procedure that is similar to minor surgery and, although rare, there may be some scratches, such as bleeding.

Usually the person is not hospitalized and returns home the same day, although it is necessary to go to the hospital accompanied, because rest is necessary and will not be able to drive after the biopsy.

What is it for

The liver biopsy is used to analyze changes in the liver, in order to define the diagnosis and be able to better plan the treatment. Key indications include:

• Evaluate chronic hepatitis, in case of doubts about the diagnosis or severity of the disease, and can also identify the intensity of liver damage
• Evaluate diseases that cause liver deposits, such as Hemochromatosis, which causes iron deposits, or Wilson's disease, which causes copper deposits, for example;
• Identify the cause of liver nodules;
• Look for the cause of hepatitis, cirrhosis or liver failure;
• Analyze the efficacy of liver therapy;
• Evaluate the presence of cancer cells;
• Search for the cause of cholestasis or changes in the bile ducts;
• Identify a systemic disease that is affecting the liver or causing fever of unknown origin;
• Analyze the liver of a possible transplant donor or even a suspected rejection or other complication after liver transplantation.

This procedure is only performed on medical advice and is usually performed only when other tests that assess the presence of lesions and liver function have failed to provide the necessary information, such as ultrasound, tomography, liver enzyme dosage (AST, ALT), bilirubins or albumin, for example. Learn more about tests that evaluate the liver.

How the biopsy is performed

To biopsy the liver, generally, a needle specially indicated for these cases is used, in order to try to remove a sample with the least possible damage to the organ.

A few different techniques can be used by the doctor, and the most common is a percutaneous liver biopsy, in which the needle is inserted through the skin into the liver, which is on the right side of the abdomen. The procedure must be performed with anesthesia or sedation and, despite being uncomfortable, this is not an exam that causes much pain.

In general, exams such as ultrasound or computed tomography are used as a guide to locate the area to be targeted, from where the sample will be collected. The doctor takes about 3 samples and the procedure takes around half an hour, depending on each case. Then the samples will be analyzed under the microscope to assess the presence of changes in the cells.

Other ways to gain access to the liver for biopsy is by inserting the needle through the jugular vein and reaching the liver through the circulation, called the transjugular route, or also during laparoscopic or open surgery, but these are ways less common.

What preparation is needed

Before performing a liver biopsy, your doctor may recommend fasting for about 6 to 8 hours. In addition, it is advised to suspend the use of drugs that can interfere with blood clotting, for about 1 week, such as anti-inflammatory drugs, anticoagulants or AAS, for example, which should be done according to medical advice.

What is recovery like

After the liver biopsy, the person needs to remain in the hospital for observation for about 4 hours. The doctor may also check blood pressure and other vital information to see if there may be any complications and if it is safe to discharge, but usually people who are well controlled can go home the same day.

The person must leave the hospital with a bandage on the side of the abdomen, depending on the type of procedure, which must be removed after 2 days, at home, after safe healing.

Before removing the bandage, care should be taken not to wet the gauze and check that it is always clean, and if there is any bleeding, pus in the wound, fever, in addition to dizziness, fainting or pain intense, it is recommended to go to the doctor for an evaluation.

To relieve pain and discomfort, your doctor may recommend taking an analgesic, and it is not recommended to exert yourself for 24 hours after the procedure.

Possible complications

Although liver biopsy is a safe procedure and there are rarely complications, bleeding, perforation of the lung or gallbladder, and infection at the needle insertion site are possible.