Leverbiopsi

Leverbiopsi, or liver biopsy, is a medical procedure used to obtain a small sample of liver tissue for histological examination. The goal is to diagnose liver disease, assess the extent of liver damage, and guide treatment decisions, including monitoring response to therapy and staging fibrosis.

Indications for leverbiopsi include unexplained elevations of liver enzymes, evaluation of suspected liver disease when imaging and blood tests are inconclusive, and assessment of fibrosis or inflammation in chronic hepatitis B or C, nonalcoholic fatty liver disease, autoimmune hepatitis, hemochromatosis, and Wilson’s disease. It may also be used to assess graft rejection after liver transplantation or to evaluate liver lesions.

The procedure is usually performed percutaneously under local anesthesia with ultrasound guidance. A fine- to medium-sized needle is inserted through the skin into the liver to obtain a tissue core. In patients with ascites or significant coagulopathy, a transjugular liver biopsy may be preferred, as it reduces bleeding risk. After obtaining the sample, the tissue is prepared for histological analysis, including standard staining and, when needed, special stains or immunohistochemistry.

Preparation typically involves reviewing medications that affect bleeding risk, correcting coagulopathy if possible, and fasting as required. Post-procedure monitoring for several hours is common to detect bleeding or pain. Risks include bleeding, pain at the puncture site, infection, injury to surrounding organs, bile leakage, and, rarely, death. The choice of leverbiopsi must weigh the diagnostic benefit against these risks.

Alternatives include noninvasive methods to assess liver fibrosis, such as elastography (ultrasound- or MRI-based) and serum biomarker panels. Histology remains the reference standard in many diagnostic situations.