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What is a liver biopsy?

Liver biopsy is a diagnostic procedure used to obtain a small amount of liver tissue, which can be examined under a microscope to help identify the cause or state of liver disease.

What are the different ways liver biopsy can be performed?

The most common way Dr. Galati performs a liver sample is obtained  by inserting a needle into the liver for a fraction of a second, making use of a special needle. This is usually performed as an outpatient and the patient is sent home after 4-6 hours of observation if there are no problems. Patients are sedated and relaxed with a combination of medications, including propofol, creating a very relaxed state. Dr. Galati determines the best site, depth and angle of the needle puncture by physical examination and the use of ultrasound. The skin and area under the skin is anesthetized, and a needle is passed quickly into and out of the liver. The majority of the  individuals have no pain afterwards, while a small percentage will experience brief localized pain that may spread to the right shoulder. Patients are able to return to work the next day following a biopsy in most situations.

When is a liver biopsy used?

Liver biopsy is often used to diagnose the cause of chronic liver disease that results in elevated liver tests or an enlarged liver. It is also used to diagnose liver tumors identified by imaging tests, such as ultrasound or cat scans. In many cases the specific cause of the chronic liver disease is suspected on the basis of blood tests, but a liver biopsy is used to confirm the diagnosis as well as determine the amount of damage to the liver. Liver biopsy is also used after liver transplantation to determine the cause of elevated liver tests and determine if rejection is present. Liver biopsies are vital in determining the extent of damage due to hepatitis C, fatty liver, and to assist in the decision to treat.

What are the dangers of liver biopsy?

The primary risk of liver biopsy is bleeding from the site of needle entry into the liver, although this occurs in less than 1% of patients. Other possible complications include the puncture of other organs, such as kidney, lung or colon. Injury to the gallbladder, a structure close to the liver maybe associated with leakage of bile into the abdominal cavity, causing abdominal pain peritonitis (inflammation of the abdomen). Fortunately, the risk of death from liver biopsy is extremely low, ranging from 0.1% to 0.01%. To reduce the risk of bleeding, medications such as aspirin, ibuprofen, Advil, Motrin, NSAIDS, heparin, warfarin, Plavix, or other blood thinners need to be stopped days to weeks before the biopsy. Fish oil supplements also decrease the ability to form a clot, increasing the chance of bleeding. Discuss these medications with Dr. Galati prior to scheduling the biopsy with the staff. If you have any questions about your medications or supplements, ask Dr. Galati and his staff.

Do liver biopsies ever need to be repeated?

In most circumstances, a liver biopsy is only performed once to confirm a suspected diagnosis of chronic liver disease. Occasionally, liver biopsy is repeated if the clinical condition changes or to assess the results of medical therapy, such as drug treatment of chronic viral hepatitis C with interferon or prednisone therapy for autoimmune hepatitis. Patients who have undergone liver transplantation often require numerous liver biopsies in the early weeks to months following the surgery to allow accurate diagnoses of whether the new liver is being rejected or whether other problems have developed. There is no danger with multiple biopsies, outside of the individual risk at the time of each biopsy.

Obesity and Fatty Liver Disease

Obesity, and all of its related complications, is more serious than most adults in America believe. More than one-third (34.9% or 78.6 million) of U.S. adults are obese. Obesity-related conditions include heart disease, stroke, type 2 diabetes, fatty liver disease, and certain types of cancer, are some of the leading causes of preventable death. We are seeing an increase in the number of young children and adolescents developing obesity, and all of the related complications.

The cost of obesity is staggering, with annual medical cost of obesity exceeding $147 billion in 2008 U.S. dollars. The medical costs for people who are obese were $1,429 higher than those of normal weight.

Dr. Galati and the Liver Specialists of Texas team are dedicated to evaluate, treat, and manage all aspects of obesity and non-alcoholic fatty liver disease (NAFLD and NASH), including the complication of cirrhosis and liver failure. Developing a customized plan of care for each patient they see is their objective.

Liver Transplant Resources

Dr. Galati has been involved in Liver Transplantation since 1989. As Medical Director for the Center for Liver Disease and Transplantation at Houston Methodist Hospital, Dr. Galati has cared for thousands of patients with advanced liver disease. In those with the most severe form of advanced liver disease and cirrhosis, liver transplantation is a life-saving surgery. For more information on liver transplantation, click here.

Indications for liver transplant include:

Online LIVER Second Opinion

  • 1

    From the comfort of your home, without the need to spend additional money on travel, lodging, and food, receive and expert second opinion from the expert physicians at Liver Specialists of Texas

  • 2

    There are five steps in the process of requesting a second opinion. We anticipate the steps will take you about 30-65 minutes to complete.

  • 3

    Have your medical records or those of your loved one on hand as you fill out the medical history questionnaire portion of the online process. The medical history questionnaire is detailed so having medical records to quickly reference will help make the process more efficient.

  • 4

    To start the process of an Online Liver Second Opinion, please fill out the initial contact form and fax back to our office. A representative from our office will call you for additional details.