Having a liver biopsy

A liver biopsy is a medical test, where we remove a small sample of tissue from your liver with a thin needle. We use X-ray, ultrasound and CT guidance to put this needle accurately into the liver. The sample is then examined in detail under a microscope.

Preparing for the procedure

You can come into hospital, have a liver biopsy and go home on the same day.

You need to have a blood test about 1 week before the liver biopsy. This is to check that your blood clotting is normal. We do the test because there is a higher risk of bleeding after a procedure if your blood is not clotting properly.

Your doctor or clinical nurse specialist explains how to arrange the blood test when they recommend a liver biopsy.

Here is more guidance about how to prepare for your liver biopsy procedure.

If you have the liver biopsy while staying in hospital, your nurse will help you to prepare.

Giving your permission (consent)

We want to involve you in decisions about your care and treatment. If you decide to have a liver biopsy, we will ask you to sign a consent form. This says that you understand what is involved and agree to have the treatment.

You can read more about our consent process.

On the day of the procedure

On the day of the liver biopsy, please arrive 15 minutes before your appointment time. This is to allow enough time to prepare.

In the interventional radiology (IR) department, you have a check-up with a nurse. They give you a hospital gown to wear and put a small plastic tube (cannula) into your arm. We can then give you medicine called a sedative to make you sleepy during the procedure, if you need it.

You can ask the IR doctor any questions that you have. We ask you to sign the consent form confirming that you agree to have the biopsy.

During the procedure

There are 2 types of liver biopsy. They are called a percutaneous biopsy and a trans-jugular biopsy.

Percutaneous biopsy

Percutaneous means through the skin. We do this type of biopsy under ultrasound or CT guidance.

1. We clean your skin with an antiseptic solution and cover it with sterile towels.
2. We inject a local anaesthetic medicine around the area where we are doing the biopsy. This means that you are awake for the procedure, but the area is numb and you do not feel pain.
3. The IR doctor uses a special needle to remove a small piece of liver tissue. They put in the needle through the skin over the liver on the upper right side of your tummy (abdomen).
4. We send the sample of liver tissue to be examined under a microscope in a laboratory.
5. We clean the wound site and put a dressing over it.

Trans-jugular biopsy

We do this type of biopsy under ultrasound and X-ray guidance. Sometimes, your doctor decides to do the liver biopsy using this method and explains why.

1. We clean the right side of your neck with an antiseptic solution and cover it with sterile towels.
2. We inject a local anaesthetic medicine to make the area numb and free from pain. You stay awake for the procedure.
3. When your skin is numb, the IR doctor puts a small tube (catheter) through a vein in your neck. The catheter is moved into the liver under X-ray guidance.
4. The IR doctor takes a small piece of tissue from the liver. They send the sample to be examined under a microscope in a laboratory.
5. We clean the wound site and put a dressing over it.

How the procedure feels

The test should not be painful, but there can sometimes be discomfort when we take the biopsy.

The position that you need to lie in during the biopsy might be uncomfortable for a short time.

If you have any pain during the procedure, please tell the nurse. They can give you pain medicine.