Liver Procedures

What is a Liver Biopsy?

A liver biopsy is a diagnostic procedure used to examine liver tissue and determine the cause of any abnormalities. This procedure is often performed after another test, such as a blood test or imaging test, indicates a problem with the liver. A liver biopsy can diagnose many problems, including cirrhosis, hepatitis B or C, and liver cancer. Results from a liver biopsy are available within a few days to several weeks.

Types of Liver Biopsy

There are several ways a biopsy may be performed; all involve the use of a needle to extract tissue samples, and all take a relatively short time, usually less than an hour. The patient is sedated and/or anesthetized and pain medication is administered as necessary. In all of these procedures, several samples of liver tissue may be removed.

Percutaneous Liver Biopsy

In this commonly used technique, a hollow needle is inserted through the abdominal wall to extract a small piece of tissue. Ultrasound, a CT scan or other imaging techniques are often used by the surgeon for guidance during the procedure.

Transvenous Liver Biopsy

This type of biopsy is performed when there is a complicating factor, such as excess fluid in the abdomen, called ascites, or when the patient’s blood clots slowly. During a transvenous liver biopsy, an incision is made into the neck, and a hollow tube, or sheath, is inserted into the jugular vein. The physician threads the sheath through the jugular vein, past the heart, and into one of the hepatic veins. Contrast dye is added so that the blood vessels and the sheath can be easily located by the doctor performing the procedure.

Laparoscopic Liver Biopsy

Laparoscopic biopsies are performed when multiple areas of the liver must be examined, or when there is a risk of spreading cancer or infection. During such a biopsy, several small incisions, rather than one large one, are made, and the doctor works with special small tools, including a miniature lighted camera.

Liver Tumors

The liver is the largest organ in the body. It performs many important functions, including breaking down and storing nutrients, secreting bile into the intestines to help in nutrient absorption, and removing toxic waste. The liver also produces clotting factors that keep cuts or injuries from bleeding excessively.

Although the specific cause of liver tumors is unknown, it is believed that they develop when the DNA of cells in the liver change, causing the cells to grow uncontrollably and eventually form a tumor. These tumors can be either benign or malignant. Primary liver cancer refers only to cancer that originates in the liver.

Types of Malignant Liver Tumors

Malignant liver tumors can be fatal, and should be treated as soon as possible to address their symptoms and prevent them from spreading to other areas of the body. Types of malignant liver tumors include:

• Hepatocellular Carcinoma
• Cholangiocarcinoma
• Angiosarcoma and Hemangiosarcoma
• Hepatoblastoma

Types of Benign Liver Tumors

Benign liver tumors are common. Usually asymptomatic, they are most often detected during imaging tests for other conditions. Because they do not spread to other areas of the body, they usually do not pose a serious health risk. If necessary, they can be removed by surgery.

• Hemangioma
• Focal Nodular Hyperplasia
• Hepatocellular Adenoma

Liver Cancer

The liver is the largest organ in the body. It performs many important functions, including breaking down and storing nutrients; secreting bile into the gallbladder to help in nutrient absorption; and removing toxic waste. It also makes clotting factors that keep cuts or injuries from bleeding excessively. One of the world’s most common cancers, most cases are found in developing countries in Africa and East Asia. Men are more likely than women to be diagnosed with liver cancer.

Because there are many different types of cells in the liver, different types of tumors can form there; they can be benign or malignant. Hemangiomas and hepatic adenomas are examples of benign liver tumors, while hepatocellular carcinoma, angiosarcoma and hemangiosarcoma are examples of malignant ones. Cancers that migrate to the liver from other organs are called liver metastases.

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