BIOPSY

[kimberlynn]

My husband is going for his biopsy on monday. I'm pretty scared because his platlets are so low, 40,000. He's not going to bleed to death or anything like that is he??  They would'nt touch him around here. We have to go to St. Loius. Washington university. Any advice would be great!!  I will let you all know his results!!  Thank you!!  Kim

[kimberlynn]

Thank you!!! I remember you too!!  Things are the same. At least I will know pretty soon how much damage his liver has.   Kim

[sunspot]

Hi Kim
How are you doing? I remember when you first came here and I hope things are doing better for you.
Best to you, Dana

[Mr Liver]

Hi Kim,

I can certainly understand your concern. Although every biopsy carries some inherent risk, it is very rare for a vein or artery to get nicked when using an ultrasound-guided, or transvenous biopsy method. This ultrasound method is practically SOC in the US, and without a doubt it would be employed at a teaching hospital if it is appropriate in this case.

A little copy and paste I found:

# Ultrasound-guided percutaneous liver biopsy can be used to guide a non-focal right lobe liver biopsy or to image, in real-time, needle sampling of a focal lesion.
# Ultrasound provides many advantages over other forms of image-guided liver biopsy.
# Use of ultrasound guidance reduces complication rates associated with percutaneous liver biopsy.
# Patients with abnormal coagulation indices benefit from an ultrasound-guided biopsy.
# Performing ultrasound-guided biopsy of a focal liver lesion may be undertaken by the free-hand method or using a transducer guidance system.

If your husband's platelets are too low for the parameters used for this method of biopsy, there is another biopsy method called transvenous biopsy, which carries a much reduced risk of bleeding complications in those patients with clotting problems. I know people who have had this method of biopsy and there is not too much difference in discomfort between the two . I'm sure they will use the proper method depending upon his latest labs before biopsy.

Biopsies are a very routine procedure and I'm sure he is in good hands. I hope the results are favorable.

Mr Liver

[Mr Liver]

I forgot to mention a laparoscopic biopsy. This is another method that can be useful in those with other complications, such as bleeding concerns. This procedure employs a scope with a camera. It is inserted through the abdomen. The docs can look at the liver in situ and retrieve samples from various parts of the liver with the use of attachments on the laparascope. It is the only biopsy method where the doc can actually see the lievr and take a close look at lesions, as well as retrieve samples.

Mr Liver

[FlGuy]

before they do the bx, if they have not already, they'll order a few tests that evaluate his condition for the biopsy.  Typically, these include 'clotting' tests (I think caller PT and INR).