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Percutaneous Liver Biopsy

AMBULATORY CARE:

What you need to know about a percutaneous liver biopsy (PLB):

A PLB is a procedure to remove a sample of tissue from your liver. The sample can be sent to a lab and tested for liver disease, cancer, or infection.

How to prepare for a PLB:

  • Your healthcare provider will talk to you about how to prepare for your procedure. You may need to have your blood tested before the procedure. A blood test can check how well your blood clots. Your blood needs to clot correctly to prevent heavy bleeding during the procedure.
  • The provider may tell you not to eat or drink anything for 6 to 8 hours before your procedure. He or she will tell you what medicines to take or not take on the day of your procedure. You may need to stop taking blood thinners, NSAIDs, or aspirin 3 to 7 days before your procedure.
  • Before the procedure you may be given an antibiotic to help prevent a bacterial infection. Tell your healthcare provider if you have ever had an allergic reaction to an antibiotic. During the procedure you may be given contrast liquid to help your liver show up better in pictures. Tell your healthcare provider if you have ever had an allergic reaction to contrast liquid.
  • Arrange for someone to drive you home and stay with you for 24 hours after the procedure. This person can help you around the house and watch you for any problems.

What will happen during a PLB:

  • You may be given local anesthesia to numb the biopsy site. With local anesthesia, you may still feel pressure or pushing during the procedure, but you should not feel any pain. You may also be given IV sedation to help you feel relaxed during the procedure. If you do feel pain during the procedure, your healthcare provider will give you IV pain medicine.
  • Your healthcare provider will make a small cut in your right upper abdomen. He or she will insert a needle through the cut. Ultrasound or CT pictures may be used to help your provider find the correct area. When the needle is in the correct position, your healthcare provider will take a sample of your liver. The needle will be removed and pressure will be applied to the biopsy site to stop bleeding. A bandage will be placed over your biopsy site.

What will happen after a PLB:

Healthcare providers will monitor your vital signs and check for bleeding at your biopsy site. You will need to lie on your right side for 1 to 2 hours. Do not get out of bed until your healthcare provider says it is okay. You may be able to go home in 4 to 6 hours, or you may need to spend a night in the hospital. You may have pain and bruising at the biopsy site. You may also have pain in your right shoulder. These symptoms should get better in 48 to 72 hours.

Risks of a PLB:

You may bleed more than expected or get an infection. The biopsy needle may make a hole in your lung, gallbladder, or kidney. You may need other procedures to treat these problems.

Call 911 for any of the following:

  • You have trouble breathing.
  • You cannot stop the bleeding from your biopsy site even after you hold firm pressure for 10 minutes.

Seek care immediately if:

  • Blood soaks through your bandage.
  • You have severe pain in your abdomen.
  • Your abdomen is larger than usual and feels hard.

Contact your healthcare provider if:

  • You have a fever or chills.
  • Your pain does not get better after you take pain medicine.
  • Your biopsy site is red, swollen, or draining pus.
  • You have nausea or are vomiting.
  • Your skin is itchy, swollen, or you have a rash.
  • You have questions or concerns about your condition or care.

Medicines:

You may need any of the following:

  • Acetaminophen decreases pain and fever. It is available without a doctor's order. Ask how much to take and how often to take it. Follow directions. Read the labels of all other medicines you are using to see if they also contain acetaminophen, or ask your doctor or pharmacist. Acetaminophen can cause liver damage if not taken correctly. Do not use more than 4 grams (4,000 milligrams) total of acetaminophen in one day.
  • Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely. Some prescription pain medicines contain acetaminophen. Do not take other medicines that contain acetaminophen without talking to your healthcare provider. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Ask your healthcare provider how to prevent or treat constipation.
  • Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Care for your biopsy site as directed:

Ask your healthcare provider when your biopsy site can get wet. Carefully wash around the biopsy site with soap and water. It is okay to let soap and water run over the biopsy site. Dry the area and put on new, clean bandages as directed. Change your bandages when they get wet or dirty. Instead, you may be told to leave the biopsy site open to air.

Self-care:

  • Apply ice on your biopsy site for 15 to 20 minutes every hour or as directed. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel. Ice helps prevent tissue damage and decreases swelling and pain.
  • Rest as directed. Do not play sports, exercise, or lift anything heavier than 5 pounds for up to 1 week.
  • Drink liquids as directed. Liquids will help flush the contrast liquid out of your body. Ask how much liquid to drink each day and which liquids are best for you.
  • Apply firm, steady pressure if bleeding occurs. A small amount of bleeding from your biopsy is possible. Apply pressure with a clean gauze or towel for 5 to 10 minutes. Call 911 if bleeding becomes heavy or does not stop.
  • Ask your healthcare provider when to take your blood thinner or antiplatelet medicine. You may need to wait 24 to 72 hours to take your medicine. This will prevent bleeding.

Follow up with your healthcare provider as directed:

Write down your questions so you remember to ask them during your visits.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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