Clinical Relevance: Percutaneous Liver Biopsy
A percutaneous liver biopsy is procedure used to obtain a sample of liver tissue. A needle is inserted through the skin to access the liver.
The biopsy is required in several clinical scenarios:
- Abnormal LFTs of unknown cause.
- Liver malignancy
- Hepatitis C – Assessment for severity of liver fibrosis and disease progression.
- Other liver conditions (such as Hereditary Haemochromatosis and Autoimmune Hepatitis).
- Following liver transplantation.
During the procedure, the liver is located via ultrasound from a subcostal approach (under the ribs). Local and deep anaesthetic is injected where good liver tissue can be seen and the needle path is free of vessels. The patient is asked to hold their breath and the biopsy is obtained.
If a patient has abnormal clotting (a relative contraindication), a percutaneous biopsy while platelets are running, or a transvenous liver biopsy can be attempted. This involves cannulating the internal jugular vein, and passing the biopsy needle through to the hepatic veins, allowing for a biopsy sample to be taken.