FACTS ABOUTLiver biopsy by bigbro22

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FACTS ABOUT: Liver biopsy

  Your health care team made this                   Carefully read the ingredients section
  handout to prepare you for a liver                 of your medication labels to look for
  biopsy. If you have any questions after            aspirin (salicylic acid) or ibuprofen
  reading it, feel free to speak with your           (Advil, Motrin). Avoid these medica-
  nurse or doctor.                                   tions for 2 weeks before your liver
                                                     biopsy. If you need a pain reliever,
  What is a liver biopsy?                            you can take acetaminophen
  A liver biopsy is a minor medical proce-           (Tylenol), or ask your NIH doctor to
  dure in which a doctor uses a needle to            prescribe something safe for you to
  remove a small piece (biopsy) of your              take.
  liver. This liver specimen is examined
                                                    If you are take an anticoagulant or
  under a microscope to establish
                                                     blood-thinner (for example,
  whether liver disease is present and
                                                     coumadin, heparin, Lovenox, Plavix)
  how severe it is.
                                                     please contact your NIH doctor for
  The liver biopsy helps your doctor plan            specific instructions.
  your care. The procedure is done with
  local anesthesia in a hospital bed. A             Each time you come to the Clinical
  small section of the specimen is saved             Center as an inpatient or as an out-
  for future study.                                  patient, always bring a list of the your
                                                     medications and the doses you take.
  What should I do before the
                                                    If you smoke and cannot stop for 2
  liver biopsy?                                      weeks before the biopsy, ask your
  Two weeks before your liver biopsy                 doctor to order a nicotine patch for
     Tell your doctor immediately if you            you.
      take aspirin or any anti-inflammatory      The day before the biopsy:
      medications, such as Indocin
      (indomethacin), Daypro (oxiprosyn),           Arrive on the inpatient unit no
      Aleve (naproxen), Motrin (ibuprofen),          later than 11 a.m. unless otherwise
      Advil (ibuprofen), or even Pepto               directed.
      Bismol. These medications contain             You will have blood drawn, urine
      salicylate, which is like aspirin.             tests, chest x-ray, and an electrocar-
      Salicylate can make you bleed easily           diogram (ECKG: heart-tracing).
      and may increase the chance that
      you will bleed after the biopsy.



Patient Education                            1                       FACTS ABOUT: Liver biopsy
    An ultrasound of your abdomen and                Before the biopsy starts, we will ask
    liver may take place the day before the            you to empty your bladder and change
    biopsy or on the day of the biopsy.                into hospital gown.
   Your NIH doctor will explain what you          You   may be asked to provide a stool
    can expect during the liver biopsy and             specimen.
    as well as its benefits and risks. You
    will have plenty of time to ask ques-          What happens during the
    tions. If you agree to the procedure,          procedure?
    the doctor will ask you to sign a con-            To help you relax, the doctor may order
    sent form.                                         a medication that the nurse will inject
   Starting at midnight the night before              into a muscle.
    the procedure, you will need to fast.             You will then be asked to lie flat on
    Fasting means that you should not eat              your back without a pillow in your
    or drink anything, including water.                hospital bed, You should extend your
What happens the day of the                            right arm above your head.
procedure?                                            At the bedside, the doctor will do a
                                                       portable ultrasound to find the exact
The morning of your biopsy                             location of your liver.
   The nurse will awaken you to insert an            You may then be given medication
    intravenous catheter (I.V.) into your              through your I.V .to relax you more,
    vein. An I.V. is a flexible plastic tube           but you will stay awake during the
    about the width of pencil lead and 1               procedure.
    inch long. It will be taped to your skin
    and will be used to give you medica-              With a special antiseptic, the doctor
    tions or fluids during the procedure.              will clean the skin over your liver
                                                       (upper right side of the abdomen).
    Please allow the nurse to start the I.V.           He or she will then use a small needle
    when she asks so that your procedure               to inject a local anesthetic under the
    can begin on time.                                 skin to numb this area.
   Fasting blood samples will be drawn.              Do not touch this clean area during the
   You will be asked for a urine specimen.            preparation.
    You will also start a 24-hour urine col-       You    will be asked to take a regular
    lection                                            breath in, let it all the way out (exhale),
   You will have an abdominal ultrasound              and then hold your breath for a few
    in the x-ray department (if one was not            seconds. The doctor may have you
    already done).                                     practice this breathing before the biop-
                                                       sy. The biopsy is completed while you


Patient Education                              2                        FACTS ABOUT: Liver biopsy
     hold your breath. The biopsy itself takes      Six 6 hours after the biopsy
     less than a second to perform.
                                                       The nurse will take a blood sample
    The doctor will get a sample of liver              from your I.V. or vein to check for
     tissue by inserting a specially designed           complications.
     needle into the space between your ribs.
                                                       You may eat a regular diet.
     He or she will rapidly move the needle in
     and out of the liver.                             You should stay on bed rest with
                                                        bathroom privileges until morning.
 A   small dressing will be put over the
     biopsy site.                                   The morning after the biopsy
 What happens after the biopsy?                        You may shower and remove the
                                                        dressing.
 Immediately after the biopsy
                                                       You may put a small bandage on the
    You will be asked to turn onto your right          biopsy site after your shower.
     side and stay in this position for 2 hours.
     This position puts pressure on the liver          Your doctor will examine you before
     so that bleeding is less likely.                   discharge
    We will monitor your blood pressure and        What to do at home after the liver
     pulse often.                                   biopsy
    If you feel pain, nausea, dizziness, short-    1. Rest and stay at home (“home rest”)
     ness of breath, or other discomforts, con-        after you are discharged from NIH.
     tact your nurse by pushing the nurse call         You may do limited activity.
     button located on your bedrail.
                                                    2. Gradually return to normal activities. Lift
     Some people feel discomfort in their              nothing heavy (over 15 pounds) and do
     right shoulder “referred pain”). Mild pain        nothing strenuous for 4 days, After that,
     medication such as acetaminophen                  you may resume normal activities.
     (Tylenol), usually relieves this discomfort.
                                                    3. Shower or bathe as usual and change
     After 2 hours, the nurse will help you           the bandage (if one was used) after
     onto your back with the head of your bed          showering. You do not need to cover the
     raised 10 degrees (one pillow).                   biopsy site after 24 hours.
    Stay on bedrest for 6 hours                    4. Look at the biopsy site daily for 1 week.
    Do not eat or drink for 3 hours after the         Notify your doctor if you notice:
     biopsy. After 3 hours, you can have clear         increased redness
     liquids.
                                                       swelling




Patient Education                            3                      FACTS ABOUT: Liver biopsy
 bloody   or pus-like drainage
 persistent   shoulder, back, or abdomial
    pain
5. For pain or discomfort, take acetamino-
   phen (regular strength Tylenol) as direct-
   ed on the package. Do not take aspirin
   or non-steroidal anti-inflammatory drugs
   such as ibuprofen (Advil, Motrin) or
   naproxen (Aleve), for at least 7 days.
If you have other questions or concerns,
call your doctor or nurse.
If you have severe pain or any sudden
severe symptoms, call 911 for an ambu-
lance and emergency care.




                                             9/07




Patient Education                       4           FACTS ABOUT: Liver biopsy

								
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