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Transjugular Liver Biopsy


What you need to know about a transjugular liver biopsy (TJLB):

A TJLB 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 TJLB:

  • 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 after midnight on the day of 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 after the procedure. This person can help you around the house and watch you for any problems.

What will happen during a TJLB:

  • You may be given local anesthesia to numb the surgery area. With local anesthesia, you may still feel pressure or pushing during surgery, but you should not feel any pain. You may also be given IV sedation to help you feel relaxed. If you feel pain during the procedure, your healthcare provider will give you IV pain medicine. Ultrasound or CT pictures may be taken to help your provider see your veins and liver more clearly.
  • Your healthcare provider will make a small cut in the side of your neck. He or she will insert a catheter into your vein. The provider will move the catheter until it reaches a blood vessel in your liver. Your healthcare provider will insert a needle through the catheter and take a sample of your liver. The needle and catheter will be removed and pressure will be applied to your wound. A bandage will be placed over your wound.

What will happen after a TJLB:

Healthcare providers will monitor your vital signs and check for bleeding from your neck vein. 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. Your neck, abdomen, and right shoulder may be sore. You may also have mild swelling and bruising in your neck. These symptoms should get better in 48 to 72 hours.

Risks of a TJLB:

You may bleed more than expected or get an infection. The catheter may make a hole in your blood vessels, lung, or liver. The catheter may cause an abnormal heartbeat when it passes through blood vessels in your heart. These problems may become life-threatening.

Call 911 for any of the following:

  • You have trouble breathing.
  • You cannot stop the bleeding from your wound 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.
  • Your neck is more swollen and you have trouble swallowing.
  • You feel weak or dizzy.
  • Your heart is beating faster than usual.

Contact your healthcare provider if:

  • You have a fever or chills.
  • Your pain does not get better after you take pain medicine.
  • Your wound 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.


You may need any of the following:

  • Acetaminophen decreases pain and fever. It is available without a doctor's order. Ask how much to give your child and how often to give it. Follow directions. Read the labels of all other medicines your child uses to see if they also contain acetaminophen, or ask your child's doctor or pharmacist. Acetaminophen can cause liver damage if not taken correctly.
  • 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 wound as directed:

Ask your healthcare provider when your wound can get wet. Carefully wash around the wound with soap and water. It is okay to let soap and water run over the wound. 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 your wound open to air.


  • Apply ice on your abdomen 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 wound 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.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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