eMedicine Specialties > Clinical Procedures > Gastrointestinal Procedures

Percutaneous Liver Biopsy: Multimedia

Author: Gaurav Arora, MD, MS, Fellow in Gastroenterology and Hepatology, University of Texas Medical School at Houston and MD Anderson Cancer Center; Former Advanced Hepatology Fellow, Division of Gastroenterology and Hepatology, Liver Transplant Program, Stanford University School of Medicine
Coauthor(s): Walid S Ayoub, MD, Clinical Assistant Professor of Medicine, Division of Gastroenterology and Hepatology and Liver Transplant Program, Stanford University School of Medicine; Emmet B Keeffe, MD, MACP, Professor of Medicine Emeritus, Stanford University Medical Center
Contributor Information and Disclosures

Updated: Apr 5, 2009

Multimedia

Deeper injection of local anesthetic.Media file 1: Deeper injection of local anesthetic.
Deeper injection of local anesthetic.

Deeper injection of local anesthetic.

Infiltrating the skin at the biopsy site.Media file 2: Infiltrating the skin at the biopsy site.
Infiltrating the skin at the biopsy site.

Infiltrating the skin at the biopsy site.

Aspirating saline.Media file 3: Aspirating saline.
Aspirating saline.

Aspirating saline.

Switching to biopsy needle.Media file 4: Switching to biopsy needle.
Switching to biopsy needle.

Switching to biopsy needle.

Making a skin nick.Media file 5: Making a skin nick.
Making a skin nick.

Making a skin nick.

Penetrating tissue planes.Media file 6: Penetrating tissue planes.
Penetrating tissue planes.

Penetrating tissue planes.

Biopsy needle inside the liver.Media file 7: Biopsy needle inside the liver.
Biopsy needle inside the liver.

Biopsy needle inside the liver.

Taking the plunger out.Media file 8: Taking the plunger out.
Taking the plunger out.

Taking the plunger out.

Transferring liver biopsy specimen to the formali...Media file 9: Transferring liver biopsy specimen to the formalin bottle.
Transferring liver biopsy specimen to the formali...

Transferring liver biopsy specimen to the formalin bottle.

Aspirating lidocaine.Media file 10: Aspirating lidocaine.
Aspirating lidocaine.

Aspirating lidocaine.

Patient lying on right side.Media file 11: Patient lying on right side.
Patient lying on right side.

Patient lying on right side.

Ultrasonography of the liver.Media file 12: Ultrasonography of the liver.
Ultrasonography of the liver.

Ultrasonography of the liver.

Hepatic parenchyma and blood vessels as seen on u...Media file 13: Hepatic parenchyma and blood vessels as seen on ultrasound.
Hepatic parenchyma and blood vessels as seen on u...

Hepatic parenchyma and blood vessels as seen on ultrasound.

Marking the biopsy site.Media file 14: Marking the biopsy site.
Marking the biopsy site.

Marking the biopsy site.

Liver biopsy tray.Media file 15: Liver biopsy tray.
Liver biopsy tray.

Liver biopsy tray.

Sterile drape application.Media file 16: Sterile drape application.
Sterile drape application.

Sterile drape application.

Percussion over the liver.Media file 17: Percussion over the liver.
Percussion over the liver.

Percussion over the liver.

Preparing the field.Media file 18: Preparing the field.
Preparing the field.

Preparing the field.

More on Percutaneous Liver Biopsy

Overview: Percutaneous Liver Biopsy
Treatment & Medication: Percutaneous Liver Biopsy
Multimedia: Percutaneous Liver Biopsy
References

References

  1. Karamshi M. Performing a percutaneous liver biopsy in parenchymal liver diseases. Br J Nurs. Jun 26-Jul 9 2008;17(12):746-52. [Medline].

  2. Myers RP, Fong A, Shaheen AA. Utilization rates, complications and costs of percutaneous liver biopsy: a population-based study including 4275 biopsies. Liver Int. May 2008;28(5):705-12. [Medline].

  3. Gilmore IT, Burroughs A, Murray-Lyon IM, Williams R, Jenkins D, Hopkins A. Indications, methods, and outcomes of percutaneous liver biopsy in England and Wales: an audit by the British Society of Gastroenterology and the Royal College of Physicians of London. Gut. Mar 1995;36(3):437-41. [Medline].

  4. Sporea I, Popescu A, Sirli R. Why, who and how should perform liver biopsy in chronic liver diseases. World J Gastroenterol. Jun 7 2008;14(21):3396-402. [Medline].

  5. Bravo AA, Sheth SG, Chopra S. Liver biopsy. N Engl J Med. Feb 15 2001;344(7):495-500. [Medline].

  6. Grant A, Neuberger J. Guidelines on the use of liver biopsy in clinical practice. British Society of Gastroenterology. Gut. Oct 1999;45 Suppl 4:IV1-IV11. [Medline].

  7. Caturelli E, Giacobbe A, Facciorusso D, Bisceglia M, Villani MR, Siena DA, et al. Percutaneous biopsy in diffuse liver disease: increasing diagnostic yield and decreasing complication rate by routine ultrasound assessment of puncture site. Am J Gastroenterol. Jul 1996;91(7):1318-21. [Medline].

  8. Howard R, Karageorge G, van Harselaar K, Bell M, Basford P, Schultz M, et al. Post-procedure surveillance in liver biopsy: how long is long enough?. N Z Med J. Aug 22 2008;121(1280):8-14. [Medline].

  9. Firpi RJ, Soldevila-Pico C, Abdelmalek MF, Morelli G, Judah J, Nelson DR. Short recovery time after percutaneous liver biopsy: should we change our current practices?. Clin Gastroenterol Hepatol. Sep 2005;3(9):926-9. [Medline].

  10. McGill DB, Rakela J, Zinsmeister AR, Ott BJ. A 21-year experience with major hemorrhage after percutaneous liver biopsy. Gastroenterology. Nov 1990;99(5):1396-400. [Medline].

  11. Froehlich F, Lamy O, Fried M, Gonvers JJ. Practice and complications of liver biopsy. Results of a nationwide survey in Switzerland. Dig Dis Sci. Aug 1993;38(8):1480-4. [Medline].

  12. Orlando G, Goffette P, Gravante G, Ciccarelli O, Lerut J. Successful treatment of haemothorax following percutaneous liver biopsy using interventional radiology: importance of arterial anatomical variations. Transpl Int. Jul 2008;21(7):708-10. [Medline].

  13. Piccinino F, Sagnelli E, Pasquale G, Giusti G. Complications following percutaneous liver biopsy. A multicentre retrospective study on 68,276 biopsies. J Hepatol. 1986;2(2):165-73. [Medline].

  14. Garcia-Tsao G, Boyer JL. Outpatient liver biopsy: how safe is it?. Ann Intern Med. Jan 15 1993;118(2):150-3. [Medline].

  15. Jacobs WH, Goldberg SB. Statement on outpatient percutaneous liver biopsy. Dig Dis Sci. Mar 1989;34(3):322-3. [Medline].

  16. American College of Physicians. Clinical Competence in Percutaneous Liver Biopsy. In: American College of Physicians Guidelines.

  17. Reddy KR, Schiff ER. Complications of Liver Biopsy. In: Taylor MB. Gastrointestinal Emergencies. 2nd. Baltimore, MD: Williams & Wilkins; 1996.

Further Reading

Keywords

percutaneous liver biopsy, liver biopsy, liver tissue sampling, hepatic biopsy, liver disease, hepatic disease, hepatic failure, liver failure, liver disease diagnosis, liver disease workup, liver disease work-up, percutaneous suction needle liver biopsy, tru-cut liver biopsy, menghini needle biopsy, modified menghini needle biopsy, jamshidi needle biopsy, liver evaluation

Contributor Information and Disclosures

Author

Gaurav Arora, MD, MS, Fellow in Gastroenterology and Hepatology, University of Texas Medical School at Houston and MD Anderson Cancer Center; Former Advanced Hepatology Fellow, Division of Gastroenterology and Hepatology, Liver Transplant Program, Stanford University School of Medicine
Gaurav Arora, MD, MS is a member of the following medical societies: American Association for the Study of Liver Diseases, American Association of Physicians of Indian Origin, American College of Physicians, American Gastroenterological Association, American Medical Association, American Society of Gastrointestinal Endoscopy, Medical Council of India, and New York Academy of Sciences
Disclosure: Nothing to disclose.

Coauthor(s)

Walid S Ayoub, MD, Clinical Assistant Professor of Medicine, Division of Gastroenterology and Hepatology and Liver Transplant Program, Stanford University School of Medicine
Disclosure: Nothing to disclose.

Emmet B Keeffe, MD, MACP, Professor of Medicine Emeritus, Stanford University Medical Center
Emmet B Keeffe, MD, MACP is a member of the following medical societies: American Association for the Study of Liver Diseases, American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Hepato-Pancreato-Biliary Association, American Medical Association, American Society for Gastrointestinal Endoscopy, American Society of Transplantation, and International Liver Transplantation Society
Disclosure: Abbott Molecular Consulting fee Consulting; Romark Laboratories Salary Employment; Roche, Bristol-Myers Squibb Honoraria Speaking and teaching

Medical Editor

Joseph K Lim, MD, Assistant Professor of Medicine, Director, Yale Viral Hepatitis Program, Section of Digestive Diseases, Yale University School of Medicine
Joseph K Lim, MD is a member of the following medical societies: American Association for the Study of Liver Diseases, American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, and American Society for Gastrointestinal Endoscopy
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Luis M Lovato, MD, Associate Clinical Professor, David Geffen School of Medicine at UCLA; Director of Critical Care, Department of Emergency Medicine, Olive View/UCLA Medical Center
Luis M Lovato, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Emergency Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Rick Kulkarni, MD, Assistant Professor of Surgery, Section of Emergency Medicine, Yale-New Haven Hospital
Rick Kulkarni, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: WebMD Salary Employment

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