Laparoscopic Liver Biopsy in India :
Minimally Invasive Surgery
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Liver Biopsy Overview
A liver biopsy is a procedure whereby small pieces of liver tissue are removed in order to be sent to a laboratory for examination. It is very helpful in the diagnosis of diseases that affect the liver.
There are several potential approaches to procuring tissue for a liver biopsy.
These are discussed below :
Percutaneous Liver Biopsy
In a percutaneous liver biopsy procedure, local anesthesia is used to numb the skin where a small incision is made. A needle the diameter of a pen refill is then passed through the skin and into the liver, where a specimen is obtained. Multiple biopsies may be taken. In these circumstances, the physician establishes where the liver lies by percussing or tapping on the skin overlying the liver and listening to the sound to find an area of dullness, under which the liver lies. Patient cooperation is critical during the procedure.
Percutaneous Image-Guided Liver Biopsy
A percutaneous image-guided liver biopsy is similar to the one described above except that the needle is guided by CT scan or ultrasound images. This is often helpful when the disease process is localized to discrete spots in the liver.
Laparoscopic Liver Biopsy
A laparoscopic liver biopsy may be done solely for the purpose of obtaining the biopsy specimen or may be part of another operative procedure. Small incisions are made in the abdomen and instruments are introduced through trocars to obtain the biopsy specimens. The laparoscope is a telescope that magnifies the objects it sees and allows excellent visualization of the liver surface. Ultrasound can be used as part of this procedure.
Open Surgical Liver Biopsy
Open liver biopsies are rarely performed today unless they are part of another operative procedure. When an open biopsy is done, the surgeon may choose to use a biopsy needle or may surgically excise a small wedge of liver tissue.
There are two main reasons why your doctor may request that you undergo a liver biopsy. (Some of the more common diagnoses for which a liver biopsy is ordered are listed in the next section.)
Diagnosis : A liver biopsy is a very important and helpful test in the diagnosis of numerous diseases that affect the liver and bile ducts. A small piece or pieces of tissue are removed from your liver and sent for examination. In most cases, this allows establishment of a very specific diagnosis.
Monitoring : A liver biopsy can help your doctor monitor the effectiveness of therapy that you are receiving for a disease that affects the liver. Likewise, it can provide a warning if certain therapies you are receiving are damaging the liver.
Reasons a Liver Biopsy is Performed
- Liver biopsy : Diagnostic purposes
- Alcoholic liver disease
- Elevated liver enzymes of unknown cause
- Biliary tract obstruction/jaundice
- Fatty liver disease
- Wilson disease
- Autoimmune liver disease
- Alpha1-antitrypsin deficiency
- Possibleinjury due to drug therapies
- Hepatitis B
- Hepatitis C
- Hepatomegaly (liver enlargement) of undetermined cause
- Cancers that originate in the liver
- Cancers that spread (metastasize) to the liver from other sites
- Noncancerous tumors or abnormalities in the liver
- Liver biopsy : Monitoring therapy
- Chronic viral hepatitis
- Liver transplantation (to rule out rejection or infection)
Exams and Tests
Your biopsy specimen will be sent for several tests. What types of tests are performed depends on the diagnosis your doctor is trying to make. Examples of some of the more common tests used to examine liver biopsy specimens include the following :
- Light microscopy with or without special stains
- Electron microscopy
- Bacterial cultures
- Virology testing
- Tumor markers
- Iron content analysis on liver biopsy to rule out hemochromatosis
Liver Biopsy Treatment
Depending on where your biopsy is performed (office or outpatient site, x-ray department, operating room) and the approach used (surgical vs. nonsurgical), one or more of the following treatment options will apply to you :
- Intravenous fluids
- Sedative drugs
- Pain killers
- Local, regional, or general anesthesia
- Antinausea drugs
Following the procedure, you will be monitored until your doctor is satisfied with your recovery. Monitoring measures will include instruments that provide information about one or more of the following :
- Blood pressure
- Heart rate and rhythm
- Breathing rate
- Oxygen levels (saturation) in your bloodstream
- Urine output
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