Techniques, Indications, Contraindications, and Complications of Liver Biopsy
Percutaneous liver biopsy is a technique whereby a needle is inserted through the skin, into the liver, to obtain a sample of tissue for histopathological examination in order to diagnose and grade any liver abnormality. The sample is usually obtained under the guidance of ultrasonography, CT scan, or MRI. Liver biopsy can also be taken via laparoscopy; however, percutaneous route is less invasive and less costly. Indications of liver biopsy are: -further evaluation of abnormal liver function test -to distinguish between non-alcoholic fatty liver disease and non-alcoholic steatohepatitis -fever of unknown origin to rule out possible cause such as tuberculosis and histoplasmosis -autoimmune hepatitis -drug-induced liver injury -post-liver transplant rejection -grading of chronic hepatitis B and C -fibrosis -hemochromatosis Liver biopsy is contraindicated in certain conditions. These are: -non-compliant patient -thrombocytopenia or coagulopathy -suspected vascular tumor -NSAID use within last 7 days -ascites -extrahepatic biliary obstruction Liver biopsy is generally a safe procedure. Rare complications are: -hypotension secondary to hemorrhage or vasovagal response -hemobilia -hemothorax -pneumothorax -portal vein thrombosis -transient bacteremia -biliary peritonitis -subphrenic abscess -death Reference: https://www.ncbi.nlm.nih.gov/books/NBK553146/ Video courtesy: https://www.youtube.com/watch?v=bFlJVosYfXM