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A liver biopsy is a procedure to remove a small piece of liver tissue by using a biopsy needle, and the pathologist can examine this tissue by using a microscope and check if there are any signs of damage or disease. Apart from the anesthesia period, the time for the biopsy takes only about 5 seconds, but the tumor biopsy must spend for more than 30 seconds. The patient will also need to lie on his or her right side to compress the puncture wound with sandbag after the procedure to prevent internal bleeding. The patient who will undergo a tumor biopsy must be admitted because he or she has a relatively high risk of bleeding after this examination.

PURPOSE OF EXAMINATION

To evaluate the severity or validate the pathogenesis when patients are diagnosed with chronical hepatitis, acute hepatitis, liver tumor, hepatomegaly, or cirrhosis.

INSTRUCTION BEFORE EXAMINATION

• Do not eat two hours before the exam.
• Avoid taking the medicine that affects coagulation, such as Aspirin, Rivaroxaban, Warfarin. (Please discuss with your physician before discontinuing these medications.)
• Please wear loose, comfortable clothing. Change of patient gown will not be needed.
• Please read the informed consent and instruction of this exam carefully. Please fully comprehend the complications of the liver biopsy. Besides, one of your family members should come with you. The exam schedule may be a little bit delayed because of unexpected clinical conditions on the examination day.
• If you have diabetes, and use medications to control your sugar, please do not use these drugs on the examination day to avoid the risk of low blood sugar.
• Empty your bladder before the examination.

INSTRUCTIONS DURING EXAM

• During the examination, lie flat or on your side with your right hand raised under your head. The doctor will select the appropriate position through ultrasound scanning.
• The doctor will disinfect the skin at the puncture site and inject local anesthetic before puncture.
• During the examination, you must follow the doctor's instructions to take a deep breath, close your mouth, and exhale.
• After examination, cover the wound with gauze and secure it with tape. You will need to lie on your side or use a corset to compress the needle site with sandbags.

POST- EXAM INSTRUCTIONS

• Compress the puncture side with sandbag after the exam for 6 hours. You may slightly turn around and lie flat for 1 minute in each hour. Alternatively, use the medical corset to fasten the sandbag and pressure for 6 hours. Do not sit up or get off the bed for eating, drinking, urination, or bowel movement.
• Eat normally after the liver biopsy. Avoid vigorous exercise in 24 hours. Remove the gauze covering the puncture area 24 hours later before taking a shower.
• Avoid carrying heavy objects for a week after the exam.
• If you have abdominal pain, shortness of breath, cold sweat, palpitation, altered mental status, notify the nurses immediately.
• If you have any discomfort after being discharged, please return to the outpatient department at Division of Gastroenterology, Department of Internal Medicine, immediately or visit the emergency department of China Medical University Hospital.

RISKS OF EXAM

• Contraindication: Patients who do not cooperate or patients with the inclination of hemorrhage.
• Complications and adverse effects: Aches or bruises on the pierced area. Drops in blood pressure. Hemorrhage in the abdominal cavity, chest or bile duct. Pneumothorax, puncture of the bile duct, and convulsion.
• Mortality less than 1/1000.