How and why is a liver puncture done? Who is shown and what are the consequences of a liver biopsy Consequences after taking a puncture from the liver

What is a liver biopsy

Why is the procedure prescribed?

Preparation for the procedure

A week before the procedure, you need to stop using aspirin as an antipyretic. All medicines that treat inflammation should be suspended for the time being. This issue is resolved with the specialist conducting the biopsy. It is he who must tell you how many days you need to stop drinking certain medications, and also when it will be possible to continue treatment with these drugs again. It is not necessary to decide on your own whether to accept them or not. Everything should take place under the strict supervision of a doctor.

Carrying out the procedure

The biopsy is done like this:

Percutaneous biopsy

• The method called "blind". With the help of ultrasound, they see where to stick the needle so that it gets to the right place. But at the same time there is no control over the correctness of the hit.
• There is not only an ultrasound check, but also a CT control during needle guidance.

Fine needle biopsy under ultrasound guidance

After the end of the biopsy

Complications

If there is an advanced stage of the disease, then you should not take risks and conduct a biopsy, as this is fraught with serious complications. So you can further worsen the patient's well-being, so the appointment occurs in the most extreme cases.

Trepan biopsy

Indications for carrying out

• Finding out details that were not clear during ultrasound or other studies.
• Determination of all available causes that indicate the formation of pathology, inflammation, viral disease or the appearance of tumor cells.
• When you need to find out the exact reasons why the liver has increased in size, as this is a sign of a serious problem that has affected the organ.
• Understanding the causes of strange yellowing of the skin without other symptoms.

Biopsy Alternative

A liver biopsy allows the doctor to make or clarify the diagnosis and treatment tactics when the informative possibilities of hardware studies have been exhausted. A biopsy is recommended for suspected oncological diseases of the organ, cirrhosis, hepatitis B and C, and other serious pathologies.

A liver biopsy (LP) shows the existence of serious pathologies in the organ.

BP is necessary in the diagnosis of the following diseases:

• non-alcoholic and alcoholic steatohepatosis;
• fatty hepatosis;
• cirrhosis;
• sarcoidosis;
• hepatitis B and C;
• primary and secondary cancer.

BP is also used:

• to detect tissue rejection after liver transplantation;
• to determine a donor for transplantation;
• monitoring the effectiveness of treatment of severe pathologies.

Contraindications for Liver Biopsy

Despite the importance of the study, it can not always be prescribed.

Absolute contraindications for liver biopsy:

• blood clotting disorder;
• sepsis;
• increased pressure in the hepatic ducts;
• ascites (abdominal dropsy);
• infectious and inflammatory diseases of the abdominal organs;
• pustules, eczema, dermatitis at the points of the proposed incision or puncture;
• mental illness, when full contact between the doctor and the patient is impossible;
• coma.

A biopsy cannot be performed in liver oncology in combination with decompensated cirrhosis.

Relative contraindications for liver biopsy:

• heart or respiratory failure;
• hypertension;
• anemia (anemia);
• respiratory tract infection;
• obesity;
• allergy to anesthetic drugs;
• refusal of the patient to undergo manipulation.

In such cases, the examination is carried out with great care or not done at all, depending on the situation. Sometimes it is necessary to wait for the stabilization of the patient's condition.

Preparation for the procedure

Preparation for the procedure includes the following nuances:

1. For a few days, you need to stop taking blood-thinning drugs or coordinate this with your doctor.
2. For 3 days, eliminate food that promotes gas formation. For 8 hours, refuse to take fluids and food (if BP is planned under general anesthesia).
3. The day before, do not overheat in the bath or bath.
4. For the day, give up heavy physical exertion. It is useful to have a good rest before manipulation.
5. Do not drink alcohol or smoke during the day.

Before performing BP, it is necessary to do an ultrasound of the liver and blood tests:

• for clotting;
• general clinical;
• RW, HIV, hepatitis;
• on the Rh factor and blood type, if they are unknown.

In the presence of other diseases, for example, heart problems, an ECG is required.

Types of biopsy and features of the study

A biopsy is a collection of a piece of liver tissue for analysis. Of the total volume of the organ, the biopsy (material taken) is approximately 1/150,000.

Research is carried out in the following ways:

• histological (tissue);
• cytological (cellular);
• bacteriological.

There are several types of BP according to the method of material sampling:

• percutaneous;
• fine needle aspirate biopsy;
• transvenous liver biopsy;
• laparoscopic and incisional.

You can learn about how a laparoscopic liver biopsy is performed from the video. Filmed by Artyom Myzin channel.

Percutaneous biopsy

Features of the event:

1. Percutaneous BP is done in a few seconds under local anesthesia and does not cause any particular discomfort to the patient.
2. Preliminary, with the help of ultrasound, the place of puncture of the abdominal cavity and the affected organ is planned. The sampling is carried out using a Menghini needle.
3. 2 hours after the manipulation, the patient is given an ultrasound scan to exclude the presence of fluid at the puncture site.

This BP method cannot be used when:

• confirmed liver hemangioma or other vascular tumors;
• echinococcus lesions;
• bleeding for unknown reasons in history;
• impossibility of blood transfusion to the patient.

Fine needle aspirate biopsy

Features of the event:

1. Fine needle aspirate liver biopsy (FNA) is performed under ultrasound or CT guidance.
2. With the help of the equipment, the doctor determines the path of the needle for taking the material. The further passage of the needle into the tissue is also monitored using ultrasound or tomography.
3. Immediately after the manipulation, the patient is given an ultrasound to check whether there is fluid at the puncture site or not.

The information content of fine-needle aspirate liver biopsy is 98.5%.

Fine-needle aspirate liver biopsy is safe for cancer patients because the method itself eliminates the "scattering" of cancer cells. But at the same time, this method is not considered 100% effective for the primary diagnosis of liver cancer. The absence of atypical cells at the puncture site does not negate the malignant nature of the disease.

Transvenous liver biopsy

Research specifics:

1. Transvenous liver biopsy (TVLB) is appropriate for patients with bleeding disorders. It is also indicated for those who purify the blood by an extrarenal method. This is a complex procedure lasting from 30 minutes to an hour.
2. Under the control of a fluoroscope, a catheter is inserted through a puncture in the jugular vein into the right hepatic vein. Through it, a needle for BP is delivered to the place of material sampling. The study is performed under local anesthesia.
3. ECG monitoring is required during the procedure. TVBP can cause arrhythmia at the time of passage of the catheter through the right atrium. In addition, the patient may experience pain at the puncture site, in the right arm.

The technique is effective for patients with the following pathologies:

• serious violation of blood coagulation;
• pronounced obesity;
• severe ascites;
• vascular tumor.

Laparoscopic and incisional technique

Laparoscopic liver biopsy (LBP) and the incisional method of conducting the study bring together the fact that both are performed under general anesthesia. Both show a good effect in a number of cases.

Procedure specifics:

1. To perform LBP, the doctor inserts a laparoscope with a video system into the abdominal cavity through incisions. The image allows you to control the moment of biopsy sampling.
2. Material for research is taken with the help of a loop or special forceps.
3. After LBP, bleeding is stopped by cauterization of tissues. A bandage is applied to the site of the incisions.

Laparoscopic BP is used for:

• development of the tumor process and determination of its stage;
• enlargement of the liver and spleen for unknown reasons;
• peritoneal infection;
• ascites of unknown origin.

An incisional liver biopsy is performed at the time of surgery to remove metastases or fragments of the affected liver. Research can be planned or emergency. If surgeons urgently need to get a histology result, the operation is suspended, and doctors wait for the verdict from the laboratory.

In addition to ultrasound and x-rays, other diagnostic methods are often used to confirm liver disease. If there is a need to take a tissue sample for examination, either a needle biopsy or laparoscopy is used. Today we will look at what is liver puncture how it is carried out.

Indications and contraindications for taking a puncture

A puncture is most often performed when a tumor is suspected, to confirm its malignancy or benignness, and is also performed for various liver diseases. Among the indications:

Fatty degeneration of the liver;

Cirrhosis of the liver;

Diseases of the gallbladder;

Diseases of the bile ducts;

Hepatitis;

Toxic damage to the liver;

Abscess;

Tumor.

In addition to the indications, there are a number of contraindications, in the presence of which the procedure is not performed:

Inflammation of the peritoneum;

Pleurisy;

Inflammation of the diaphragm;

Violation of the functions of the heart;

Hemophilia;

Violations of the circulatory system. Also liver puncture not recommended for cancer patients and suspected hemangioma.

How is the puncture performed?

The first step will be a survey and a small examination, after which an intravenous catheter will be installed. It is necessary to sign a special form confirming the patient's consent to the operation. Before that, the doctor, of course, will talk about all the risks and benefits of this procedure. This will be followed by a diagnostic study - ultrasound, with its help the puncture site is determined. Only then will local anesthesia be performed. With the help of a special puncture needle, a puncture is made in the liver area. The whole operation is carried out under the supervision of an ultrasonic echoscope. The needle is inserted directly into the liver tissue, so the doctor receives a tissue sample. This sample is sent to the laboratory for analysis.

How dangerous is a puncture?

In fact, conducting this study is quite dangerous. That is why it should be carried out by an experienced doctor. Such doctors work in our center. Only with a professionally performed puncture can various complications be avoided:

Damage to internal organs;

infections;

internal bleeding;

Inflammation of the peritoneum;

Fistula.

Preparing for a liver puncture

Before carrying out this procedure, you need to prepare. About a week before the puncture, stop taking blood thinners. It is not recommended to take aspirin and preparations containing it. Do not drink or eat for 8 hours before the puncture. You can only take medications that are approved by your doctor. No other special preparation is required, but in any case, consult your doctor on this issue. It is best to get such advice from the specialists of our center.

After a liver puncture

Within 4 hours after the procedure, you must be under medical supervision. During this time, you can not go to the toilet. You may feel some discomfort and a slight tingling at the injection site, but this goes away on its own after about 2 days. The results of the study of liver tissue will be ready within 3 days. Based on the results, the doctor will determine the next steps. If treatment or surgery is needed, they will be carried out immediately. In order to undergo a liver puncture, you just need to contact our center. Our specialists will do everything quickly and efficiently. After the procedure, the necessary control of the condition will follow, which will avoid possible complications. Only in our center the most modern diagnostic equipment is used, highly qualified specialists work. By contacting our center, you will receive professional qualified assistance.

There are diseases in which the results of blood tests and ultrasound diagnostics are not enough to make a correct diagnosis, determine the degree of compensation for chronic pathologies or the severity of the inflammatory process. In such cases, they resort to informative, but at the same time more complex instrumental research methods.

Liver puncture (biopsy) is an example of such manipulation. It is carried out in order to clarify the anatomical and physiological features of the gland cells, as well as to detect infectious processes. The procedure consists in taking a piece of organ tissue and its further examination. Biopsy is considered a safe diagnostic method, however, it is important that a highly qualified specialist participate in the implementation. The following describes how a liver biopsy is done and what are the features of the procedure.

Diagnosis is carried out in several cases: to confirm clinically established pathologies and suspected lesions of the gland, or if a number of systemic diseases are suspected.

Needle liver biopsy is necessary for the following liver diseases:

• an increase in the size of an organ of unknown etiology;
• increase in quantitative indicators of ALT, AST in the blood;
• yellowing of the skin and sclera of unknown origin;
• confirmation of acute hepatitis, its degree, cause, possible outcome;
• formation of a diagnosis and determination of compensation for chronic inflammatory processes;
• differential diagnosis of lesions that arose against the background of alcohol abuse;
• confirmation of the presence of tumor processes and their malignancy;
• suspicion of drug or toxic damage to the gland;
• control over prescribed therapy.

Organ puncture is done with systemic pathologies:

• hyperthermia of unknown origin;
• determination of the presence of metastases of tumors of other organs in the liver;
• confirmation of tuberculosis, sarcoidosis;
• diseases of the hematopoietic system of unknown origin;
• enlargement of the spleen of an unspecified nature;
• confirmation of liver rejection during transplantation.

Contraindications

Needle liver biopsy is not recommended for severe coagulopathy (blood clotting disorder), low platelet counts, or the presence of echinococcosis. The procedure is not carried out in the case of a suspected hematoma of the gland, since bleeding may develop. Such conditions are absolute contraindications.

There are pathologies in which biopsy is prohibited, however, after stabilization of the patient's condition, puncture is allowed. These include the accumulation of pathological fluid in the abdominal cavity, inflammation of the pleura of the right lung, cholangitis, blockage of the elements of the biliary system of any origin.

Preparation for manipulation

A puncture biopsy of the liver is performed after preparing the patient on an outpatient or inpatient basis. Before the procedure, the specialist collects an allergic history, clarifies the presence of diseases of the heart and kidneys. If medications that affect blood clotting are used in the treatment, the diagnostician should be informed about this.

Non-steroidal anti-inflammatory drugs should be stopped 7 days before a liver biopsy, however, this is allowed only on the recommendation of a treating specialist. Blood tests are repeated the day before the procedure.

2-3 days before the puncture, refuse products that affect the formation of gas in the intestines. For prevention, you can take Espumizan. The last intake of food in the body should be on the evening before the procedure. In the morning it is no longer possible to eat, you can only drink water (it is allowed with general anesthesia, during general anesthesia, even water must be abandoned).

Percutaneous biopsy

Manipulation takes place under local anesthesia, duration - 5-10 minutes. For percutaneous puncture, several techniques are used:

In order for the diagnostic results to be informative, it is necessary to obtain gland tissue with dimensions of 10-30 mm x 1.5-2 mm.

The doctor anesthetizes the necessary intercostal space. The needle is inserted into this gap slightly anterior to the midaxillary line in the place where the greatest dullness on exhalation during percussion is determined. The patient is lying down at this time. The instrument is gently but quickly inserted into the gland with further aspiration or tissue excision.

Transvenous puncture

It is carried out by patients who are on hemodialysis (hardware blood purification), or those who have problems with blood clotting indicators. A catheter is inserted through a vein in the neck or groin. Under the control of a special apparatus, it is carried out to the right hepatic vein. Further, material is taken through the catheter for histological examination.

This manipulation is longer, can last up to 1 hour. During the introduction of the catheter and puncture, the state of the heart and the rhythm of its contractions must be monitored, since during this period the risk of developing arrhythmia is very high.

Laparoscopic biopsy

This procedure must be done under general anesthesia. It is carried out under the following conditions:

• the need to determine the malignancy and stage of the tumor process;
• accumulation of pathological fluid in the abdominal cavity of unknown origin;
• development of peritoneal infection;
• simultaneous enlargement of the liver and spleen of unknown origin.

Contraindications consider severe heart or lung failure, the development of bacterial peritonitis, intestinal obstruction.

The doctor makes an incision 2-3 cm long and inserts a laparoscope through it. This is a special tool that has optics at the end. The camera, located in the same place, displays the image of the organ on the monitor screen. Not far from the first incision, the doctor makes 2 more of the same in order to introduce additional instruments and take the material. After taking liver tissue, the instruments are removed.

After a biopsy performed by any of the methods, the subject must lie on his right side for another 2 hours. This will put pressure on the puncture site to reduce the risk of bleeding and other possible complications. A few hours after the manipulation, the doctor conducts a control ultrasound examination. If all is well, the patient is allowed a light meal.

After returning home:

• if the patient was prescribed sedatives, you can not drive;
• until the evening it is desirable to observe bed rest;
• for 7 days it is necessary to abandon physical activity;
• check with the diagnostician or the attending physician when you need to resume taking medications;
• clarify when you can take water procedures, wet the puncture site.

The results are ready in a few weeks.

Possible consequences

Early complications occur in the first few hours after the procedure. If the integrity of the branches of the portal vein is damaged by a needle, bleeding may occur. This condition occurs in 0.2% of needle biopsy cases. Every third patient complains of pain at the sampling site. The pain may radiate to the stomach, right shoulder. Stopped by conventional painkillers.

Perhaps the development of a condition called hemobilia. This is bleeding into the intestinal tract from the bile ducts. Develops within three weeks from the moment of a liver biopsy. Patients complain of pain, jaundice, discoloration of feces (it turns black).

The puncture should be carried out exclusively by a qualified specialist, since the possible risk of damage to the walls of the large intestine and neighboring organs is quite high.

It is necessary to consult a doctor if you develop hyperthermia, chills, swelling or redness in the puncture area. Severe soreness, bouts of nausea and vomiting, dizziness, shortness of breath and cough should alert.

Evaluation of results

In order to determine the degree of inflammation and damage to the gland, the Knodel method is used. Diagnostic criteria are evaluated on a special scale:

• the presence of dead tissue zones (1-10 points);
• dystrophy inside the lobules of the gland (1-4 points);
• the presence of fibrosis (1-4 points);
• quantitative indicators of infiltrated portal triads (1-4 points).

Metavir scale

Used to determine the presence of fibrosis:

• 1 - no pathology;
• 2 - development of portal fibrosis;
• 3 - pathology extends beyond the portal triads;
• 4 - widespread fibrosis;
• 5 - cirrhosis.

The results obtained are interpreted by the treating specialist. On their basis, the diagnosis is confirmed or refuted, if necessary, the tactics of managing the patient and the treatment regimen are selected.

The number of patients with liver diseases is constantly increasing, but a puncture () is prescribed to units. This is explained by the fact that the procedure causes pain and is accompanied by serious complications. In most cases, instrumental and laboratory methods are capable of determining the origin and characteristics of the pathology. A liver metastasis biopsy allows you to analyze the condition of the cells, monitor reproduction, and consider the degree of necrosis.

Thanks to the puncture, the specialist regulates the course of treatment or corrects the prescribed therapy, determines the likelihood of a malignant formation and reveals rare diseases of the liver tissue.

Indications for liver biopsy

There is a myth among patients that a biopsy is performed only when.

In reality, a study for pack changes is not the only indication for a biopsy, it is advisable:

• when determining the degree of organ damage;
• if previous analyzes showed the presence of a pathological process;
• in order to assess the effectiveness of therapeutic therapy;
• to analyze the degree of survival of a transplanted organ;
• causeless increase in bilirubin;
• analysis of the suitability of a potential donor liver for transplantation.

Biopsy sampling is required in the presence of pathological conditions:

• liver damage from alcohol;
• the formation of adipose tissue in the liver;
• hepatitis B, C;
• autoimmune hepatitis;
• Wilson-Konovalov pathology;
• biliary cirrhosis.

For other diseases, it is better to use other diagnostic methods to minimize the chance of complications and serious side effects.

Contraindications for liver biopsy

The specialist, before prescribing a biopsy, conducts a number of additional diagnostic measures, which will allow you to check the body for contraindications:

• disorders of the nervous system;
• unconscious state of the patient;
• the presence of fluid in the abdominal cavity;
• impaired blood clotting;
• allergy to anesthetics;
• problems with the permeability of the vascular walls.

Each of the varieties of the procedure has its own contraindications, so you need to consider them in more detail.

Types of biopsy

To take a part of the liver tissue, specialists use various techniques, the choice of which is based on the characteristics of the disease and the patient's condition. All of these methods have individual advantages and disadvantages.

• Laparoscopic biopsy. It is carried out exclusively in the operating room. For this, general anesthesia is used. The specialist makes several holes in the right hypochondrium, through which he introduces a working tool and a video camera. The process is controlled by broadcasting the picture on the screen.
• transvenous biopsy. It is carried out by those patients who, for various reasons, cannot be operated on the abdomen. This is a common contraindication for impaired blood clotting. The doctor cuts the jugular vein, connects the catheter, moves it to the veins of the organ and takes a certain amount of material.
• liver. A syringe is used to implement the procedure. A puncture is made between the ribs, tissue is taken for the purpose of further analysis of the liver for a biopsy. You can control the movement of the needle through ultrasound.
• open biopsy. It is performed during a surgical intervention, when a specialist removes a tumor or an element of the affected organ.

Each method has a different efficiency, most often a needle biopsy is used, since it is easy to implement, and the effectiveness reaches 98%. The transvenous version is performed under anesthesia, the duration of the whole process is no more than 60 minutes. Previously, the patient is connected to an electrocardiographic apparatus, since there is a possibility of arrhythmia.

Features of preparation for a biopsy

Each procedure needs preparatory measures. The liver biopsy is no exception, so it is important to carefully and responsibly treat the preparation.

Before conducting, you must follow the following rules:

1. 7 days before the procedure, the use of all medications aimed at reducing the inflammatory process should be canceled.
2. It is mandatory to inform your doctor about the use of anticoagulants.
3. A few days (more than 3) you can not eat food that leads to increased gas formation. Such products include raw vegetables, black bread, milk, fruits. If the patient has problems with the digestive system, you can take "Espumizan", the active components of the drug reduce bloating.
4. If the biopsy is scheduled for the morning, then in the evening you can eat until 21:00. Some experts recommend cleansing the body with an enema.
5. An additional ultrasound is performed before the biopsy.
6. Be sure to examine the blood for clotting.
7. The physician should be aware of all possible allergic reactions, susceptibility to heart disease.

Almost all patients are worried about the pain of the procedure, although it is almost imperceptible, since it is performed under anesthesia.

How is a liver biopsy done?

The specialist informs the patient about possible complications and discomfort. A liver biopsy is a rather complicated procedure, so it is carried out in a special room. With increased anxiety of the patient or excessive excitability, medications of the sedative group can be used.

How is a liver biopsy done?

1. The patient takes a position lying on his back, lays his right hand behind his head and maintains absolute immobility.
2. The puncture area is treated with antiseptic agents, after which anesthesia is administered.
3. The doctor makes an incision in the skin, passes the needle through the hole to the required depth and collects a biopsy.

A tissue fragment makes up 0.00002% of the total organ volume, because its size does not exceed 3 cm in length and 2 mm in diameter. The procedure will show a high level of efficiency if there are at least 3 portal tracts in the test material.

A needle biopsy takes about 15 minutes, while the process of taking tissue lasts about 60 seconds. The transvenous version of the procedure has a longer duration due to the difficulty of access to the organ.

Results of histological and cytological studies

The taken material is sent for detailed analysis to the laboratory. Various methods are used for evaluation, the most popular are the Metavir and Knodel methods. The first was created specifically for the study of affected tissues in hepatitis C. A biopsy determines the degree of the inflammatory process and the stage of the disease. The laboratory assistant gives scores from 0 to 4, which allows the specialist to further assess the patient's condition.

According to the stage of inflammation, the degree of scarring and the amount of fibrous tissue can be analyzed.

Each score has a precise definition:

• "0" - indicates the absence of scars;
• "1" - a small number of formations;
• "2" - scarring extends to neighboring structures;
• "3" - the occurrence of bridging fibrosis, in which the affected parts of the liver rally with each other;
• "4" - a deep degree of scarring, which is the first sign of cirrhosis.

The second method in medical practice has received another name - the "method of histological activity." It requires more time, although its accuracy is much higher than that of the previous method. For evaluation, a score scale from 0 to 18 is used, each value indicates the degree of the inflammatory process, in comparison with a normal sample:

• "0" - absent;
• "1-4" - minimum;
• "5-8" - insignificant;
• “9-12 - moderate;
• "13-18" - significant.

With liver pathologies, information about the degree of inflammation and the stage of fibrosis allows the doctor to conduct effective treatment.

Possible complications and consequences of a biopsy

The safety of the procedure directly depends on the patient's condition, the degree of organ damage and the qualifications of the health worker.

The following complications may occur after a liver biopsy:

1. Pain. This problem is the most common, manifesting itself 2-3 hours after the puncture. Patients note dull and low-intensity pain sensations, they completely disappear after a week.
2. Bleeding. A little bleeding after surgery is normal. With an increase in blood loss, the specialist decides on a blood transfusion or in an additional operation to eliminate the complication.
3. Damage to tissues and organs. A side effect is a consequence of the blind biopsy method, when the specialist does not have the ability to control the movement of the game. As a result of this process, the instrument can hook on the lungs, gallbladder, adjacent tissues, etc.
4. infectious infection. It occurs in rare cases when pathogens enter the body through an open incision.

Each of the above complications requires the attention of a specialist. Therefore, if any clinical manifestations occur, you should visit a medical institution.

Patient care after a biopsy

Upon completion of the biopsy, the patient should spend another 4 hours in a supine position, during which it is strictly forbidden to leave the bed, eat any food and go to the toilet. Be sure the patient must be under the constant supervision of medical professionals, since complications may occur in the next few hours.

After some time, the effect of anesthesia will end, there will be pain in the right hypochondrium, they can spread to the abdominal cavity, shoulders and even the lower back. If the pain increases and you have to endure it through force, then the specialist can administer an additional dose of painkiller.

Where can you get the procedure?

A liver biopsy is performed in almost any regional hospital, only in Moscow there are about ten such medical institutions. The cost directly depends on the region and the scope of the direction of the clinic. In the capital, the price of a liver biopsy starts from 4,000 rubles. For more information about the amount and other conditions, you can find out directly at the medical facility.

It is first necessary to study the reviews from patients to ensure the reliability and credibility of the institution. Much depends on the qualifications of the specialist, this directly affects the effectiveness of the biopsy and possible complications.

A liver biopsy is an indispensable procedure for pathological processes that are associated with the inflammatory process, pathogenic microorganisms and malignant tumors. When other methods of instrumental and laboratory research have proven ineffective, this diagnostic measure will be the best solution. The cost of such an examination costs an average of 5,000 to 26,000 rubles.