Did you ever have a liver biopsy?

January 2, 2007 9:09 AM

Have any MeFites had a liver biopsy? I'm scheduled for a liver biopsy as an outpatient procedure in the middle of January, and finding myself a little nervous about it; I'd appreciate it if anyone who has gone through it could tell me I'm getting myself nervous about nothing.
posted by WCityMike to health & fitness (16 comments total)

My brother had one and I attended the proceedure. A topical anesthetic was administered and a small incission was made where a doctor guided a small tube like instrument to the liver while a video of the tube going to the liver was monitored by a nurse. The doctor activated a device that "pinched off" a piece of the liver and it was removed when the tube was pulled out. A couple of stitches later, that was it. No pain was involved when taking the actual biopsy. I thought "not too bad" concidering the sound of the proceedure. My brother said it wasn't that bad. Hope you get good news and good luck...Orlin
posted by orlin at 9:35 AM on January 2, 2007

I haven't personally gone through it, but there's a little description of a liver biopsy at hepcboy.com. Here's a link to the write-up. Scroll down a teeny bit to the little picture of the guys drilling into the ice in the arctic. He describes the process in detail, and it doesn't seem too bad at all. Good luck!
posted by Verdandi at 9:38 AM on January 2, 2007

Someone very close to me has had this done recently. She said that when the small section of liver was pinched off it was quite painful, but only lasted a second or two. She then had to lie very still in the same position for a couple of hours afterwards to make sure there was no internal bleeding. A walkman helped here to occupy the time. She was told to not lift anything heavy for the next 10 days and said that she couldn't have even if she wanted to - she felt like she had pulled a muscle in the general liver area. Nothing painful, just a nagging ache for about a week. All in all she found herself freaked out over not much. Good luck!
posted by meerkatty at 10:12 AM on January 2, 2007

I doubt anything said here will be as valuable as discussing your concerns and anxiety with the doctor directly. Good luck!
posted by Octoparrot at 10:48 AM on January 2, 2007

Just to clarify, after reading that article Verdandi linked to, in case anyone ever goes a-huntin' into my 'Net footprint ... this isn't due to hepatitis, it's due to NAFLD, which I understand is fairly common.

I appreciate the answers given so far, and would also most definitely appreciate hearing of anyone else's experiences as well.
posted by WCityMike at 10:53 AM on January 2, 2007

I know someone who had a liver biopsy. I believe he was sedated for the procedure, so if you're nervous about the actual stabby stab, talk to your doctor about getting a Valium or something. Otherwise, you'll want to be still for a few days afterward and avoid laughing too hard, but there shouldn't be awful pain.
posted by thirteenkiller at 11:01 AM on January 2, 2007

WCityMike:

I did this about 8 years ago or so. I remember it being much like orlin described. You'll get a local, and you'll want to take it very easy for a couple of days. But after that, you'll be fine. Avoid the heavy lifting and heavy exercise for as long as your doctor tells you, but if you do get diagnosed with fatty liver (which is very very common), you'll want to get back on the exercise train as quickly as your doctor will allow.

And just for emphasis, I'm seconding (thirding? fourthing?) everyone else's advice to check your concerns and questions with your doctor, but I also want you to know that you'll do just fine. It's a very routine procedure, they'll take a very very teensy bit, and thanks to the amazing recuperative powers of the liver, you'll be good as new in no time!

Best,

d.j.j.d.
posted by deejay jaydee at 11:53 AM on January 2, 2007

About a year ago, I had a friend who had a liver biopsy who said it was the most excruciating 10 seconds of pain that she'd ever felt. And to make matters worse, the doctor didn't get a big enough sample the first time, so he had to go back in and slice off some more, which she said hurt just as much as the first time. Even so, she walked out of the hospital a couple of hours later and bounced back to a 100 percent in a matter of days.

On the other hand, my father had a liver biopsy a few months ago, and he said it wasn't a big deal at all -- and seemed very surprised when I told him about my friend's painful experience. He described the actual procedure as a "slight uncomfortable feeling" but didn't even go as far as calling it pain.
posted by TBoneMcCool at 12:13 PM on January 2, 2007

I had a CT-guided liver biopsy last year. My procedure was done with a needle and was more like the one described in the article Verdandi linked to than the one that orlin described. Everyone involved in my care was very helpful and informative and there was plenty of time before the procedure for questions. The procedure was explained to me at least four times, but I was still pretty nervous about it, especially about being awake for it. Having been through it now, I wouldn't be at all nervous or worried if had to get it done again.

If I remember correctly, I was given an IV when I first arrived, but now I can't remember why as I didn't have any pain meds or sedatives (contrast maybe?). I laid flat on my back on the CT table and the tech took a couple of scans before the doctor came in. As they took each scan, I had to take in a breath and hold it. I was supposed to try to take the same size breath each time. After looking at the scans, the doctor came in and gave me a local anesthetic. I think that was the most painful part of the whole procedure. Then he asked me to take a breath and hold it, and inserted the needle to collect the sample. Again if I'm remembering it correctly, I think he did this two or three times. After that it was bandaged and I was brought back to the outpatient recovery area. I had to lay on my right side for what felt like a really long time (an hour or two I think) and then I was allowed to go home. I didn't need any painkillers or anything afterward and I don't remember being especially uncomfortable, though I did have some shoulder pain.

Good luck!
posted by curie at 12:40 PM on January 2, 2007

The risk of dying because of a liver biopsy is about 1 in 100.
posted by ikkyu2 at 2:38 PM on January 2, 2007 [1 favorite has favorites]

I had one done about a month and a half ago, ultrasound used to find where to place the needle. The actual stab'n'snip was in fact quite painful, even under sedation, but very brief, and after about 2 hours of observation, I was released from the hospital. The rest of the day was painful, especially movement involving the torso or non-shallow breathing. After a good night's sleep, most of that went away, though I still had twinges of pain and discomfort for a week or two.


The risk of dying because of a liver biopsy is about 1 in 100.

It's that high? *Now* I'm freaked out. 1 in 100 patients who have a liver biopsy die from it? Are there other factors correlated with those who suffer life-threatening problems from the biopsy?
posted by weston at 3:02 PM on January 2, 2007

Ikkyu mistyped or is screwing with you. The risk of death during a liver biopsy is closer to 1 in 10000.
posted by Simon! at 3:57 PM on January 2, 2007

I'll stand by that number. Folks with liver disease are often coagulopathic, though - blood doesn't clot because the liver isn't making clotting factors - and so if you're not in that group the biopsy is much safer.
posted by ikkyu2 at 10:08 PM on January 2, 2007

I'm a bit concerned. A lot of people here seem to be indicating it's a rather painful process.
posted by WCityMike at 7:41 AM on January 3, 2007

Hm. Just to go over the responses more accurately, firsthand recountings indicate it was "no pain at all" (hepcboy.com); "quite painful" (weston); or presumably not too painful, since the anesthetic was the more painful of the two (curie). Secondhand responses indicate it "wasn't that bad" (orlin), "quite painful" (meerkatty), the "most excruciating 10 seconds of pain ever felt" (TBoneMcCool), or "wasn't a big deal at all" (same).

I had hoped to get a sense of how painful this procedure was going to be. It is quite frustrating to instead find that people's reactions have it falling anywhere on the spectrum of pain from no pain at all to the most excruciating pain I've ever felt.

Also, ikkyu, I'm not sure where you're getting this 1 in every 100 liver biopsies result in death. Admittedly, I am only working off of Google, but I don't see mention of a 1% fatality rate anywhere.
posted by WCityMike at 8:19 AM on January 3, 2007

As a follow-up in case anyone discovers this via Google, it was by no means excruciating. The actual process was a bit like getting poked with something rather hot, and I was one of those people who got the referred shoulder pain -- but that was about the equivalent of someone digging into my right shoulder really, really hard with their hand, just a really nasty muscle contraction, that's all. The aftereffect so far (I had it Thursday afternoon) is a soreness equivalent to someone having punched me rather badly in the spot, and that hopefully is fading.

A good read in case anyone is going to do this is Ed Dewke's "My Liver Biopsy" -- quite comforting to me prior to the actual incident.
posted by WCityMike at 10:48 AM on January 22, 2007