LIVER BIOPSY (Repost)

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LIVER BIOPSY

          What is a Liver Biopsy?
          Who needs a liver biopsy?
          How is a Liver Biopsy done?
          What are the risks associated with a Liver Biopsy?
          What happens after a Liver Biopsy?

     WHAT IS A LIVER BIOPSY?

A liver biopsy is a procedure by which a thin core of liver tissue is
obtained for analysis under a microscope. It is probably the oldest of all
the procedures done by your gastroenterologist. It is said to have been
first performed by Paul Erlich in 1883. The basic technique has been refined
since then. These refinements have decreased the risk to a degree that a
liver biopsy is commonly done on an outpatient basis.

     WHO NEEDS A LIVER BIOPSY?

Since liver biopsy is considered the "gold standard" its indications are
many and varied. The clinician uses the information obtained to guide his
treatment or assess the extent and severity of liver damage. Some of the
more common indications are:

a.Chronic viral hepatitis like Hepatitis B and Hepatitis C.
b.Unexplained liver enlargement and liver tests.
c.Alcohol induced liver disease.
d.Drug induced liver damage.
e.Space occupying liver lesions like tumors and cancers.
f.Systemic diseases and infections affecting the liver.
g.After liver transplantation for rejection and other complications.
h.Assessment of response to treatment.
i.Storage diseases of the liver.

     HOW IS A LIVER BIOPSY DONE?

Most liver biopsies are done on an outpatient basis i.e. the patient stays
in the hospital for half a day. The doctor orders tests to check bleeding
and clotting times. Patient's blood group is known and blood available if
needed. All recent medications are reviewed. Aspirin and aspirin like
medications should have been stopped. Under full aseptic precautions the
right side of the chest is cleaned and numbed using local anesthesia.
Breathing techniques are practiced with the patient. Using a long fine
needle a core of liver tissue is obtained. The actual process takes only 1-2
seconds. This process is repeated and another specimen obtained. A dressing
is applied and the patient lies on his/her right side for about 2 hours and
on the back for another 2 hours. After about 4-6 hours a blood sample is
drawn. If this sample is similar to the one drawn before the biopsy, no
bleeding has occurred and the patient is discharged home. The patient spends
the rest of the day resting at home. He/She should not be alone and should
have easy access to a phone and a hospital.

Sometimes a liver biopsy is done by a Radiologist using an ultrasound or CT
scan to guide the needle(US or CT guided liver biopsy). In patients with a
bleeding disorder it can be done by a catheter inserted into a neck vein and
advanced into the liver (transjugular liver biopsy). Rarely it has to be
done via a tube inserted into the abdomen (laparoscopic liver biopsy). Your
Borland-Groover Clinic physician will be able to decide which technique is
best for you.

     WHAT ARE THE RISKS ASSOCIATED WITH A LIVER BIOPSY?

A liver biopsy is by and large a safe procedure. The risk of dying is about
1 in 10,000 procedures. The various reported complications are.

a.Bleeding: This is an uncommon but serious complication. It is
usually controlled by observation and blood
transfusion, but may require surgery to stop it.
b.Injury to the Gallbladder.
c.Bleeding into the bile ducts.
d.Injury to the kidney and colon.
e.A connection between a vein and an artery called a fistula.
f.Irritation of the covering of the lung or liver (Pleurisy or
perihepatitis).

     WHAT HAPPENS AFTER A LIVER BIOPSY?

The day after a liver biopsy the patient can resume his normal lifestyle.
Over the next week the liver specimen undergoes extensive evaluation under a
microscope by a pathologist skilled in liver diseases. Special stains (dyes)
are used to highlight various aspects of the liver. This result is made
available to your gastroenterologist who uses this information for
diagnosis, treatment decisions and to assess the prognosis.

This is a brief and simplified overview of a liver biopsy. If you have any
questions or clarifications please contact physician who will be happy to
discuss it further with you.

雪绒花

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