Percutaneous liver biopsy

Key points below

Your child’s liver biopsy is scheduled for (date) ______________ at (time) ____________.Stop at the Welcome Desk for directions when you get to the hospital. Some procedures are done in Day Surgery and some are done in Imaging (Radiology).If you need to cancel the procedure, please call the GI office at (414) 266-3690. If you are cancelling the morning of the procedure, please also call Day Surgery (414) 266-3536.

What is a percutaneous liver biopsy?

A liver biopsy is a test used to get a small piece of liver tissue. The tissue is looked at under a microscope. Percutaneous means the needle goes through the skin to reach the liver.

When is it needed?

When blood tests show that the liver is not working like it should or it is swollen.
When the liver is larger than it should be.
After transplant, to find the cause of the liver problem or to see if the liver is being rejected.
The risks and benefits of the procedure are:

Risks

These risks are rare. They may mean your child needs emergency surgery after the liver biopsy:

Internal bleeding from the needle going into the liver.
Needle puncture of other organs such as the kidney, lung or colon.
Allergic reaction to anesthesia or medicine.
An infection caused by the procedure.

Benefits
Your child’s doctor will be able to:

Find out why your child’s blood tests are not normal for liver function.
See how much damage has been done to your child’s liver.
See if there are signs of rejection after a liver transplant.

How is the biopsy done?

Your child will be asleep during the procedure. An IV is started to give your child medicine for sleep. This is called sedation. A needle is put in the liver for a few seconds to get the liver tissue. The tissue is sent to the lab. The procedure takes less than an hour. Your child may have pain after the biopsy. Pain medicines will be given if needed.

What will happen before the procedure?

A nurse from Day Surgery or Radiology will call you 1 to 3 days before the test. The nurse will go over important directions about when to stop eating and drinking the night before the biopsy.
Your child may eat as normal the day before the procedure. After midnight, your child may have only clear liquids until 2 hours before the time you were told to arrive tat the hospital.
The night before the biopsy, your child’s belly needs to be washed with soap and water. This will help prevent infection.
Your child will need to have blood drawn. This may be done the day before or the day of the procedure. You must take your child to the lab and have the labs drawn before reporting for the biopsy. The results need to be back before the biopsy can be done. The blood test is done so that blood could be given if there is some bleeding after the procedure.

What will happen after the procedure?

Your child will need to stay quiet in bed for 6 hours after the test. Your child’s nurse will watch your child. The nurse will check your child’s blood pressure, heart rate and the biopsy area for bleeding. If your child is in pain, medicine will be given. A blood test will be done 4 hours after the procedure to make sure there are no changes from the earlier blood tests.
There is a chance your child may need to stay overnight for monitoring. This is done to provide the best and safest care for your child.

What care is needed after leaving the hospital?

You will need to stay within a 30 minute drive of the hospital for the first 24 hours after the biopsy. This is because a small number of patients may need to return to the hospital for care if there are signs of bleeding after leaving the hospital. If needed, find a list of local hotels on the Children’s Wisconsin website: https://childrenswi.org/patients-and-families/milwaukee-campus/inpatient-visit/before-your-visit/where-you-can-stay

There must be a parent or adult with your child to watch for any changes for 48 hours after the procedure. After you leave the hospital, call (414) 266-2000 and have the GI Fellow paged if your child:

Has bleeding at the biopsy site.
Looks pale.
Has a hard time breathing.
Is very sleepy and hard to wake up.
Has severe pain that is not helped by pain medicine.
Has a fever over 101° F (38.3° C).
Call 911 if your child has a lot of bleeding or you are not able to wake your child up.

Bathing and wound care

Keep the foam pressure dressing on for 24 hours. Change it to a regular Band-Aid after 24 hours. Your child can shower after 48 hours. Keep the area clean and dry during healing. The wound should not be under water until the steri-strips have fallen off. Call the clinic If any drainage or pus starts or there is more swelling, redness or pain in the area.

Activity

Your child will need rest after the procedure. The next day, your child may return to quiet activities. There should not be any heavy activity, heavy lifting, rough play or contact sports for one week. Your child should not go swimming or take a bath until the biopsy site is healed. This is about 7 to 10 days. A regular shower is allowed.

When will the results be ready?

The results of the biopsy will be back in about 7 to 10 days. There are several steps in the process that need to take place before a plan can be made. The nurse from the clinic will call you as soon as this information is available.

ALERT

Call your child’s doctor, nurse, or clinic if you have any questions or concerns or if your child has:

Any signs listed above within 48 hours of the procedure. You must call the GI Fellow to get directions for returning to the hospital for care: 414-266-2000.