In medical practice, in recent years, visual research methods (ultrasound, x-ray) have significantly improved. But sometimes they are not enough to correctly diagnose. For some pathologies, a tissue sample is required. To avoid surgery to obtain cells, a liver biopsy is used. How to do such a procedure? Why is she prescribed? And how is the research?
Let's get it right.
What is a liver biopsy?
This is a special medical study that allows you to identify various abnormalities in the body at the cellular level.
We will analyze in general terms, if a liver biopsy is prescribed, how this procedure is done. Using a special needle, they take a small area of tissue, which is sent for laboratory study. The procedure is considered quite a complex manipulation.
The question often arises as to whether a liver biopsy is painful. The study practically does not bring discomfort to the patient, since it is performed under anesthesia.
Why is the procedure prescribed?
It is widely believed among patients that a liver biopsy is prescribed only if the doctor suspects cancer. But this is far from the only reason that a study may be prescribed.
The procedure is recommended in the following cases:
- a blood test gives reason to suspect liver disease;
- studies (ultrasound, x-ray, MRI, CT) indicated a problem with the body;
- establish the degree of liver damage ;
- the patient needs to plan the right treatment;
- after the prescribed therapy, the dynamics should be determined.
Remember, if a liver biopsy is prescribed for you, how to do the procedure and why, the doctor will explain to you in detail.
The study is prescribed for a variety of pathologies, including when:
- non-alcoholic fatty liver disease ;
- chronic hepatitis B or C;
- alcoholic liver disease;
- primary biliary cirrhosis;
- autoimmune hepatitis;
- primary sclerosing cholangitis;
- Wilson-Konovalov disease.
Preparation for the procedure
The patient who is prescribed a biopsy of the liver how to do the procedure will explain in detail the doctor. He will explain in detail what to expect from this examination.
The patient should tell the doctor about all the medicines that he takes. This applies not only to prescription drugs, but also vitamins, herbal supplements.
On the eve of a biopsy, the patient is canceled with medications, supplements that can lead to bleeding:
- Painkillers such as Aspirin, Ibuprofen.
- Blood thinners, such as Warfarin.
- Certain dietary supplements that reduce the risk of sudden bleeding.
In addition to taking medications, it is important to inform your doctor about your health condition. Pay particular attention to the following points:
- confirmed or possible pregnancy;
- allergic reactions to medicines or latex;
- recent pneumonia;
- Do you have ascites?
- diseases of the circulatory system.
Before the procedure
After explaining how a liver biopsy is done (the photo in the article allows you to familiarize yourself with the procedure), the doctor will prescribe a patient examination:
- Blood analysis. It is recommended to the patient to determine the level of blood coagulation. If the examination reveals a problem, then immediately before the procedure, the doctor will give the subject a medicine that reduces the risk of bleeding.
- Ultrasound The study allows you to study the anatomical features of the structure of the organ.
When all tests are done, the doctor will schedule a biopsy day. 10 hours before the procedure, you must stop eating. 8-6 hours before the manipulation, liquid should be discarded. Immediately before the biopsy, the patient will be advised to empty the bladder. After all, after the procedure, the patient can not immediately rise.
Liver biopsy
How do the procedure?
Manipulation consists of the following stages:
- Before the procedure, a sedative drug is administered intravenously.
- The patient will be asked to undress. He lies on his back and puts his right hand under his head.
- The area of the skin through which the puncture will be carried out is disinfected. Local anesthesia is administered in this area.
- The doctor, using a manual examination or using an ultrasound machine, will find the liver. A special needle for a biopsy is inserted through the skin between the two right lower ribs. To facilitate the passage of the needle, the patient may be asked to exhale and hold their breath for a while. Such an event will protect against accidental puncture of the lung.
- If necessary, the doctor will perform another puncture, but from a different angle.
- The procedure lasts about 15-30 minutes.
If oncology or cirrhosis is suspected, a liver biopsy can be performed in a slightly different way. How is this manipulation done in cancer? A biopsy is sometimes done with laparoscopy.
Types of Procedure
There are several varieties of this manipulation. And only a doctor can tell how to do a liver biopsy.
One of the following methods may be recommended to the patient:
- Percutaneous biopsy. This is the most common way. This method was considered above.
- Transjugular biopsy. The patient lies on his back, on an X-ray table. The doctor injects anesthesia into the neck. Then a small incision is made and a flexible plastic tube is inserted into the jugular vein . She carefully screwed into the vessel. When the tube reaches the hepatic vein, a contrast agent is injected into it and a series of shots are taken. A tissue sample is then taken through the tube. The catheter is carefully removed. A bandage is applied to the neck.
- Laparoscopic biopsy. The procedure is performed under general anesthesia. The patient does not feel anything. The patient is placed on the operating table. The doctor makes several or one small incision in the abdomen. Through the incisions, special tools are introduced, as well as a small video camera projecting an organ image on the monitor. The doctor sees the organ in detail. This allows you to take all the necessary tissue samples. After removal of the instrumentation, the incisions are sutured.
After the procedure
Now you know if a liver biopsy is prescribed, how the procedure is done. The rehabilitation period completely depends on the type of manipulation.
As a rule, the patient is recommended:
- After a biopsy, the patient is transferred to the ward. The nurse controls the patient’s pulse, pressure and breathing.
- A person is not allowed to get out of bed for 2-4 hours if a percutaneous biopsy has been performed. With other varieties of the procedure, this time increases.
- A patient who has been given sedative drugs should not drive. It is better to ask relatives to take you home from the clinic.
- During the day, you should not lift weights.
- Pain at the puncture site may persist for up to a week.
- You can return to normal activities after 1-2 days.
Possible complications
If the biopsy is performed by an experienced doctor, then this is a completely safe procedure.
However, sometimes the following consequences may occur:
- Pain. Discomfort after the procedure is the most common complication. Most often we are talking about small painful sensations. In case of severe discomfort, the patient is prescribed analgesic therapy.
- Bleeding. Some patients may experience this complication. If the bleeding is severe, then the patient will need a blood transfusion or surgery.
- Infection A rather rare complication. Bacteria can enter the abdominal cavity through an incision or puncture.
- Accidental damage to nearby organs. This is extremely rare. A needle can injure neighboring organs (lung, gall bladder).
Patient opinion
Now consider what patients think of such a procedure as liver biopsy. How do they do it?
Testimonials from patients show that an event almost always causes fear in a person. However, the biopsy itself is quite easy. Some people experience slight pain. But the discomfort is quite bearable.
Patients who fully comply with all the doctor's prescriptions, practically do not encounter complications.
In specialized medical institutions, liver biopsy is a common procedure. Therefore, it is not worth fearing.