Last updated: 11/24/2009

Liver biopsies require some preparation by the patient. Since aspirin and ibuprofen (Advil, Motrin) are known to cause excessive bleeding by inhibiting platelets and lessening clotting function, the patient should avoid taking any of these medications...

for at least a week before the biopsy. The doctor should check the patient's records to see whether he or she is taking any other medications that may affect blood clotting. Both a platelet count (or complete blood count) and a prothrombin time (to assess how well the patient's blood clots) are performed prior to the biopsy. These tests determine whether there is an abnormally high risk of uncontrolled bleeding from the biopsy site, which may contraindicate the procedure. The patient should limit food or drink for a period of four to eight hours before the biopsy.

Patients should be told what to expect in the way of discomfort pre- and post-procedure. In addition, they should be advised about what medications they should not take before or after the biopsy. It is important for the clinician to reassure the patient concerning the safety of the procedure.

Before the procedure, the patient or family member must sign a consent form. The patient will be questioned about any history of allergy to the local anesthetic, and then will be asked to empty the bladder so that he or she will be more comfortable during the procedure. Vital signs, including pulse rate, temperature, and breathing rate will be noted so that the doctor can tell during the procedure if the patient is having any physical problems.

When performing the liver biopsy and blood collection that precedes it, the physician and other health care providers will follow universal precautions to maintain sterility for the prevention of transmission of blood-borne pathogens.

Some patients should not have percutaneous liver biopsies. They include those with any of the following conditions:

• a platelet count below 50,000
• a prothrombin test time greater than three seconds over the reference interval, indicating a possible clotting abnormality
• a liver tumor with a large number of veins
• a large amount of abdominal fluid (ascites)
• infection anywhere in the lungs, the lining of the chest or abdominal wall, the biliary tract, or the liver
• benign tumors (angiomas) of the liver, which consist mostly of enlarged or newly formed blood vessels and may bleed heavily
• biliary obstruction (bile may leak from the biopsy site and cause an infection of the abdominal cavity)