Liver Biopsy by Laparoscopy

What is a liver biopsy by laparoscopy?

A liver biopsy is removal of liver tissue for examination under a microscope. Laparoscopy is a surgical procedure that is done to get the tissue. Your healthcare provider uses a lighted tube with a camera called a laparoscope. The scope is placed through a small incision (cut) near the belly button. It lets your provider look inside the belly and see the abdominal organs on a TV monitor. Your healthcare provider uses this view to take tissue from the liver with other tools.

This procedure can help your healthcare provider make a more accurate diagnosis. Then your provider can suggest further treatment.

The time needed to recover from a laparoscopy is shorter than if you have open abdominal surgery. You will also have smaller incisions.

When is it used?

This procedure may be done when you have had other tests that suggest something is wrong with your liver. A liver biopsy can help your provider learn more about your liver problem. If you have a cancerous tumor in the liver, you may have the procedure to see if it will be possible to remove the tumor with more surgery.

Instead of this procedure, other ways to get a sample of tissue may include:

• having open abdominal surgery, which uses a larger cut in the belly
• using a CT scan and needle and to get a tissue sample from the liver (a CT scan is a series of X-rays taken from different angles and arranged by a computer to show thin cross sections of parts of the body)

You may choose not to have treatment. Ask your healthcare provider about your choices for treatment and the risks.

How do I prepare for this procedure?

• Make plans for your care and recovery after you have the procedure. Find someone to give you a ride home after the procedure. Allow for time to rest and try to find other people to help with your day-to-day tasks while you recover.
• Follow your healthcare provider's instructions about not smoking before and after the procedure. Smokers may have more breathing problems during the procedure and heal more slowly. It is best to quit 6 to 8 weeks before surgery.
• Some medicines (like aspirin) may increase your risk of bleeding during or after the procedure. Ask your provider if you need to avoid taking any medicine or supplements before the procedure.
• You may or may not need to take your regular medicines the day of the procedure, depending on what they are and when you need to take them. Tell your provider about all medicines and supplements that you take.
• Your provider will tell you when to stop eating and drinking before the procedure. This helps to keep you from vomiting during the procedure.
• Follow any other instructions your healthcare provider gives you.
• Ask any questions you have before the procedure. You should understand what your healthcare provider is going to do.

What happens during the procedure?

This procedure will be done at the hospital or a surgery center.

You will be given regional or general anesthesia to keep you from feeling pain during the procedure. Regional anesthesia numbs part of your body while you stay awake. General anesthesia relaxes your muscles and you will be asleep.

Your provider will make a small cut near your bellybutton. Your abdominal cavity will be inflated with carbon dioxide gas. This gives your healthcare provider more space to work in and a better view of the organs inside your belly.

Your provider will put a laparoscope through the cut and another tool through a second small cut in your abdomen. The laparoscope is used to look at the liver and guide the other tool. If your provider finds a growth that should not be there, he or she may take a sample of the growth or remove it. Tissue that is removed will be sent to the lab to be examined under a microscope.

At the end of the procedure your provider will release most of the gas through the laparoscope, remove the scope and any other tools, and sew up the cuts.

The procedure will take about 30 minutes.

What happens after the procedure?

You may stay in the hospital for a few hours or overnight to recover, depending on what was done during the procedure. The anesthetic may cause sleepiness or grogginess for a while.

You may have some pain after the procedure. Your provider will give you instructions on how to treat any pain.

You may go home with a catheter, which is a small tube used to drain urine from your bladder. Your healthcare provider will decide when the catheter can be removed during a follow-up visit.

You may feel bloated or have constipation for a few days. Eating fruits and vegetables and drinking extra fluids may help you avoid constipation. If diet and extra fluids are not enough to avoid constipation, then your provider may recommend a stool softener or a laxative. Check with your provider if constipation is still problem.

Ask your healthcare provider:

• how and when you will hear your test results
• how long it will take to recover
• what activities you should avoid and when you can return to your normal activities
• how to take care of yourself at home
• what symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

What are the risks of this procedure?

Your healthcare provider will explain the procedure and any risks. Some possible risks include:

• Anesthesia has some risks. Discuss these risks with your healthcare provider.
• The intestines, other abdominal organs, glands, or blood vessels may be damaged. You may need abdominal surgery to repair them at the time of the laparoscopy.
• The lining of the abdominal cavity may become inflamed.
• You may have infection or bleeding.

There is risk with every treatment or procedure. Ask your healthcare provider how these risks apply to you. Be sure to discuss any other questions or concerns that you may have.