Liver Biopsy for Diagnosis of Liver Diseases | Hepatitis of Liver

What is Liver Biopsy?

Liver Biopsy is a safe, simple and valuable method for diagnosis of liver diseases.

When Liver Biopsy is Advised?

• Chronic Hepatitis with or without cirrhosis is the most important indication.
• In patients with chronic active hepatitis on steroids or antiviral therapy, it helps to assess the effects of therapy.
• It helps to diagnose types of cirrhosis, non cirrhotic portal fibrosis, alcoholic liver disease, drug induced hepatitis, storage disorders such as amyloidosis and glycogen storage disorders.
• In patients with space occupying lesions such as granulomas due to tuberculosis or malignancy, liver biopsy should be best done under vision during laparoscopy.

Liver Biopsy Techniques

• Patient is admitted to the hospital for liver biopsy.
• Hemoglobin should be around 10 gram %.
• Blood group should be known and facilities for blood transfusion must be available.
• Platelet count, bleeding count, clotting count and prothrombin must be within normal limits
• Procedure is normally done on a fasting patient under local anesthesia without sedation, using intercostals technique (8^th or 9^th space) with the patient holding his breadth in expiration for a few seconds during puncture.
• Several needles are available for liver biopsy.
• The menghini needle obtains a specimen by aspiration it has diameter of 1.4 mm, oblique tip and has a blunt nail within its shaft to prevent fragmentation of specimen.
• The trucut needle is a sheathed needle with 1.7 mm diameter and biopsy with it is obtained by cutting process.

Contraindications and Complications of Liver biopsy

• Liver biopsy is contraindicated in patients with suspected angiomas, coagulation disorders, in patients with tense ascites, hydatid cyst of liver.
• Complications of liver biopsy include serious intra-peritoneal or intra-thoracic hemorrhage, pleurisy and Intra hepatic haematomas.
• Therefore liver biopsy though simple to perform must be done with utmost care by an experienced person.

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