Liver biopsyLLiver biopsyLiver biopsyEnglishOtherChild (0-12 years);Teen (13-18 years)LiverLiverTestsCaregivers Adult (19+)NA2016-04-05T04:00:00ZMichelle Côté, BScN, RN;Constance O’Connor, RN(EC), NP8.0000000000000063.00000000000001747.00000000000Health (A-Z) - ProcedureHealth A-Z<p>Learn what a liver biopsy is, why it is required and how to prepare your child for the procedure.</p><h2>What is a liver biopsy?</h2><p>A liver biopsy is a procedure done to obtain a small sample of the liver so it can be examined under a microscope. A liver biopsy can help your child’s doctor identify problems in the liver, find the cause of liver disease, and/or determine how much damage is in the liver.</p> <figure><span class="asset-image-title"></span><span class="asset-image-title"></span><span class="asset-image-title">Liver</span><img src="https://assets.aboutkidshealth.ca/akhassets/IMD_liver_EN.jpg" alt="" /><figcaption class="asset-image-caption">The</figcaption><figcaption class="asset-image-caption"></figcaption><figcaption class="asset-image-caption"> liver is an organ that is part of our digestive system. It helps us get rid of toxins, digest food, and store energy from food.</figcaption> </figure> <h3>What is the liver?</h3><p>The <a href="/Article?contentid=1468&language=English">liver</a> is an organ in our belly (abdomen). It helps our bodies remove toxins and waste. It also stores some of the energy we get from food and also helps with food digestion by producing bile fluids. The bile helps with digestion of fat from food.</p><h2>Key points</h2> <ul> <li>A liver biopsy is a procedure during which a tiny piece (sample) of the liver is obtained and examined under a microscope.</li> <li>Liver biopsy may help identify problems in the liver.</li> <li>Liver biopsy is carried out at the hospital. Your child will be closely monitored before being sent home when it is safe to do so.</li> <li>Explain to your child using simple words what is going to happen.</li> </ul><h2>On the day of the liver biopsy </h2><p>Arrive at the hospital well before the planned time of your child’s procedure. Follow your hospital’s directives.</p><p>There, your child will be dressed in a hospital gown, weighed and a nurse will make sure your child is healthy enough to have the procedure.</p><p>You will also be able to speak to the interventional radiologist who will be doing the liver biopsy, and the nurse or anaesthetist who will be giving your child anaesthetic or sedation.</p><p> During the liver biopsy you will be asked to wait in a waiting room. </p><h2>Your child will have medicine for pain </h2><p>Children are given medicine for treatments that may be frightening, uncomfortable, or painful. This includes local anaesthesia, sedation or general anaesthesia. The type of medicine that your child will have for the procedure will depend on your child’s condition.</p><p>Feel free to discuss your questions or concerns with your health-care team.</p><h2>How is a liver biopsy performed?</h2><p>Your child’s doctor will discuss with you the best way for your child to have a liver biopsy before arranging the procedure. The approach to your child’s liver biopsy will be determined by a number of factors, including how well your child feels and the type of liver problem that the doctor suspects.</p><p>The procedure usually takes about one hour.</p><h3>Anaesthesia</h3><p>Right before the procedure, your child will receive a local anaesthesia (“freezing”). This means that only a specific, limited area of your child’s abdomen (belly) will be numbed so they will not feel pain from the biopsy. They may also receive <a href="/Article?contentid=1260&language=English">sedation</a> or <a href="/Article?contentid=1261&language=English">general anaesthesia</a>, which will make your child sleep or feel sleepy throughout the procedure and prevent them from feeling pain during the biopsy.</p><h3>Image guided procedure</h3><p>In most cases, a specialized doctor called an interventional radiologist carries out the liver biopsy using image guidance. The interventional radiologist uses an <a href="/Article?contentid=1290&language=English">ultrasound</a> machine to precisely locate the liver and help identify the biopsy site.</p><p>After cleaning the skin, the radiologist inserts a hollow needle through the skin into the liver and then the biopsy device is inserted into the hollow needle and quickly withdrawn. This removes a tiny liver sample. The radiologist usually takes two to three samples, by re-inserting the biopsy device through the needle. The samples will then be sent to the lab for examination under a microscope.</p><p>The small hole made by the needle may bleed. The doctor puts a small plug in to stop the bleeding. The plug does not need to be removed; it will disappear on its own. A small bandage will be placed over the biopsy site. No stitches are needed. </p><h3>Other image-guided biopsy procedures</h3><p>In some special cases, like such as when children have blood clotting problems or fluid in their belly, doctors will instead do a transvenous liver biopsy. This is done by inserting a small tube through a vein in your child’s neck and pushing it all the way to your child’s liver to take a small sample of liver tissue. This procedure limits the risk of bleeding.</p><h2>After the procedure </h2><p>After the liver biopsy is complete, the interventional radiologist will talk to you about the details of the procedure. Your child will be moved to the recovery area. As soon as your child starts to wake up, a nurse will come and get you so you can be with them.</p><p>Your child will be monitored closely until they can safely go home. The time of discharge is usually between six and 24 hours. It differs depending on the age and health of the child, and the reason for the biopsy.</p><p>Your child will have a blood test about six hours after the biopsy to check any changes in <a href="/Article?contentid=1541&language=English">blood counts</a> and make sure the liver is not bleeding. An ultrasound scan may be ordered. Your child may have to stay on bed rest or be admitted overnight for further observation if your doctor feels it necessary. </p><h2>Going home </h2><p>Most children older than one year of age who have a liver biopsy go home the same day. </p><p>Babies under one year of age and children who are or become unwell may need to be admitted to hospital after the procedure.</p><p>Follow your health-care team’s instructions to <a href="/Article?contentid=1239&language=English">care for your child at home</a>.</p><h2>How to prepare for liver biopsy</h2><h3>Clinic visit to prepare for liver biopsy (pre-procedure appointment) </h3><p>The radiologist and their team will see most children for assessment a day or two before the procedure. During the clinic visit you should expect:</p><ul><li>a physical health assessment and blood work to make sure that your child is healthy and that it is safe to have local anaesthesia, sedation or general anaesthesia</li><li>an overview of the procedure, and a review of the consent form with an interventional radiologist</li><li>a quick ultrasound of the liver to locate the biopsy site; it will be then marked with a semi-permanent marker on your child's abdomen.</li></ul><p>In some cases, your child may need to be admitted to hospital before having a liver biopsy. Your child’s doctor or nurse will give you specific instructions about where you need to take your child before the liver biopsy.</p><h3>Giving consent before the procedure</h3><p>Before the procedure, the interventional radiologist will:</p><ul><li>explain how and why the procedure is done</li><li>the potential benefits and risks</li><li>discuss what will be done to reduce these risks</li><li>help you weigh the potential benefit of the procedure against any risk it may pose for your child. </li></ul><p>Signing the consent form means you agree to the procedure. Before you do so you should understand all the risks and potential benefits of the liver biopsy. Make sure you get answers to all your questions. A parent or legal guardian must sign the consent form for children who are not able to give consent.</p><p>The procedure will not be performed unless you give your consent. </p><h3>How to prepare your child for the procedure</h3><p>You should talk to your child about what will happen before any treatment. Children feel less anxious and scared when they know what to expect. Children also feel less worried when they see their parents are calm and supportive. </p><p>When talking to your child, use words they can understand. Let your child know that they will receive medicines to make them feel comfortable during the procedure. </p><h3>If your child becomes ill within two days before the procedure </h3><p>For their own safety, it is important that your child is healthy on the day of the procedure. If your child starts to feel unwell or has a fever within two days before the liver biopsy, let your doctor know. Your child’s procedure may need to be rebooked.</p><h3>Food, drink and medicines before the procedure </h3><p>Your child’s stomach must be empty before sedation or general anaesthetic. Thus on the day of the liver biopsy, your child will have to fast (stop eating and drinking) several hours before the procedure. The length of time required for <a href="http://www.sickkids.ca/VisitingSickKids/Coming-for-surgery/Eating-guidelines/index.html">fasting</a> will depend on your child’s diet and the type of food and drink consumed. Your child’s health-care team will give you specific instructions about fasting.</p><p>Please follow the fasting guidelines carefully because it is unsafe for your child to have sedation or anaesthesia if they have eaten or had anything to drink too close to the procedure time.</p><p>If your child has special needs during fasting, talk to your doctor to make a plan.</p><p>Your child can take their regular morning medicine with a sip of water up to two hours before the procedure. </p><p>Medicines such as <a href="/Article?contentid=77&language=English">acetylsalicylic acid (ASA)</a>, <a href="/Article?contentid=198&language=English">naproxen</a>, <a href="/Article?contentid=153&language=English">ibuprofen</a>, <a href="/Article?contentid=265&language=English">warfarin</a>, or <a href="/Article?contentid=129&language=English">enoxaparin</a> may increase the risk of bleeding. If your child is taking any of these medicines, please discuss this with your doctor and the interventional radiologist to make a plan for the time of the procedure. </p>​​<h2>At SickKids</h2> <p>The radiologist and their team will assess your child in the Image Guided Therapy department a day or two before the procedure.</p> <p>On the day of the liver biopsy, SickKids’ staff asks that you come two hours before the procedure.</p>
Biopsie du foieBBiopsie du foieLiver biopsyFrenchOtherChild (0-12 years);Teen (13-18 years)LiverLiverTestsCaregivers Adult (19+)NA2016-04-05T04:00:00ZMichelle Côté, BScN, RN;Constance O’Connor, RN(EC), NP8.0000000000000063.00000000000001747.00000000000Health (A-Z) - ProcedureHealth A-Z<p>Découvrez en quoi consiste une biopsie du foie, à quoi elle sert et comment préparer votre enfant à subir l’intervention.</p><h2>En quoi consiste une biopsie du foie?</h2><p>Une biopsie du foie est une intervention au cours de laquelle on prélève un petit échantillon de tissu du foie afin de l’examiner au microscope. Une biopsie du foie peut aider le médecin de votre enfant à identifier des problèmes du foie, à trouver la cause d’une affection du foie et/ou à déterminer les dommages causés au foie.</p> <figure> <span class="asset-image-title">Le foie</span> <img src="https://assets.aboutkidshealth.ca/akhassets/IMD_liver_FR.jpg" alt="" /> <figcaption class="asset-image-caption">Le foie est un organe qui fait partie de notre système digestif. Il contribue à l’élimination des toxines, à la digestion des aliments et au stockage de l’énergie provenant des aliments.</figcaption> </figure> <h3>Qu’est-ce que le foie?</h3><p>Le <a href="/Article?contentid=1468&language=French">foie</a> est un organe situé dans le ventre (l’abdomen). Il aide l’organisme à éliminer les toxines et les déchets. Il stocke également une partie de l’énergie que nous recevons des denrées alimentaires et contribue à la digestion des aliments en produisant le fluide biliaire. La bile aide à digérer le gras des aliments. </p><h2> À retenir</h2> <ul><li>Une biopsie est une intervention au cours de laquelle est prélevé un petit échantillon du tissu hépatique afin de l’examiner au microscope.</li> <li>Une biopsie du foie peut aider à identifier des problèmes du foie.</li> <li>Une biopsie du foie est pratiquée à l’hôpital. Votre enfant sera observé de près avant de pouvoir rentrer à la maison en toute sécurité.</li> <li>Expliquez à votre enfant en termes simples ce qui va se passer.</li></ul><h2> Le jour de la biopsie</h2><p>Rendez-vous à l’hôpital bien avant l’heure prévue de l’intervention de votre enfant. Suivez les directives de l’hôpital. Là, votre enfant sera vêtu d’une chemise d’hôpital, pesé et le personnel infirmier s’assurera que son état de santé lui permet de subir l’intervention.</p><p>Vous pourrez aussi parler au radiologue d’intervention qui pratiquera la biopsie et au personnel infirmier ou à l’anesthésiste qui administrera l’anesthésie ou la sédation à votre enfant.</p><h3>Votre enfant prendra des médicaments antidouleur</h3><p>On administre un médicament aux enfants pour des traitements qui peuvent être effrayants, inconfortables ou douloureux. Il peut s’agir d’une anesthésie locale, d’un sédatif ou d’une anesthésie générale. Le type de médicament qui sera administré à votre enfant est fonction de son état de santé.</p><p>N’hésitez pas à discuter de vos questions ou de vos préoccupations avec votre équipe de soins de santé.</p><h2>Comment se déroule une biopsie du foie?</h2><p>Avant d’organiser l’intervention, le médecin discutera avec vous de la meilleure façon de procéder pour faire une biopsie du foie à votre enfant. L’option choisie sera déterminée par un certain nombre de facteurs, y compris comment votre enfant se sent et le type de problème hépatique que soupçonne le médecin.</p><p>L’intervention prend habituellement environ une heure.</p><h3>Anesthésie</h3><p>Juste avant l’intervention, on administrera à votre enfant une anesthésie locale («région endormie»), c’est-à-dire que seule une région déterminée et limitée de son abdomen (ventre) sera engourdie (« endormie ») afin qu’il ne sente pas la douleur de la biopsie. On peut également lui administrer une <a href="/Article?contentid=1260&language=French">sédation</a> ou une <a href="/Article?contentid=1261&language=French">anesthésie générale</a>, ce qui l’endormira ou le rendra somnolent tout au long de l’intervention afin de l’empêcher de ressentir de la douleur durant la biopsie.</p><h3>Thérapie guidée par l’image</h3><p>Dans la plupart des cas, un médecin spécialisé appelé un radiologue d’intervention effectue la biopsie hépatique à l’aide de la thérapie guidée par l’image. Il utilise un <a href="/Article?contentid=1290&language=French">échographe</a> pour localiser le foie avec précision et l’aider à identifier le site de la biopsie.</p><p>Après avoir nettoyé la peau, le radiologue y insère une aiguille creuse et la dirige vers le foie. Le dispositif servant à la biopsie est inséré dans l’aiguille creuse, puis rapidement retiré prélevant un petit échantillon de tissu hépatique. Le radiologue prend habituellement deux ou trois échantillons de tissu, en réinsérant le dispositif dans l’aiguille. Les échantillons sont ensuite envoyés au laboratoire pour examen au microscope.</p><p>La petite incision faite par l’aiguille peut saigner. Le médecin pose un petit bouchon pour arrêter le saignement. Ce bouchon n’a pas besoin d’être retiré; il va se désintégré. Un petit pansement sera placé sur le site de la biopsie. Aucun point de suture n’est nécessaire. </p><h3>Autres types de biopsie guidée par l’image</h3><p>D’autres enfants peuvent avoir une biopsie du foie faite par un chirurgien au bloc opératoire. Dans certains cas particuliers, comme par exemple lorsque les enfants ont des problèmes de coagulation du sang ou des liquides dans l’abdomen, les médecins opteront plutôt pour une biopsie hépatique transveineuse. Il s’agit d’insérer un petit tube dans une veine du cou de votre enfant et de pousser le tube jusqu’à son foie pour prendre un petit échantillon de tissu hépatique. </p><p>Cette procédure limite le risque de saignement.</p><h2>Après l’intervention</h2> <p>Après la biopsie, le radiologue d’intervention vous fera part des détails de l’intervention. Votre enfant sera amené dans la zone de récupération. Quand votre enfant commencera à se réveiller, le personnel infirmier vous préviendra afin que vous puissiez le joindre.</p> <p>Votre enfant sera observé de près jusqu’à ce qu’il puisse rentrer à la maison en toute sécurité. Le congé de l’hôpital est habituellement autorisé de 6 à 24 heures après la biopsie, mais cela varie avec l’âge et la santé de l’enfant ainsi que la raison de la biopsie.</p> <p>On fera un prélèvement sanguin à votre enfant environ six heures après la biopsie pour détecter tout changement dans ses marqueurs et s’assurer qu’il n’y a aucun saignement au foie. Une échographie peut être prescrite. Votre enfant pourrait devoir rester alité ou être admis à l’hôpital pour la nuit en observation si votre médecin l’estime nécessaire. </p> <h2>Retour à la maison</h2> <p>La plupart des enfants âgés de plus d’un an qui ont une biopsie du foie rentrent à la maison le même jour.</p> <p>Les bébés de moins d’un an et les enfants qui sont malades ou le deviennent doivent être admis à l’hôpital après l’intervention.</p> <p>Suivez les directives de votre équipe de soins de santé en ce qui concerne les <a href="/Article?contentid=1239&language=French">soins à donner à votre enfant à la maison​</a>.</p> <h2>Comment se préparer à une biopsie du foie</h2><h3>Visite à la clinique pour se préparer à une biopsie du foie (consultation avant l’intervention)</h3><p>Le radiologue et son équipe rencontreront la plupart des enfants pour une consultation un jour ou deux avant l’intervention. Lors de la consultation en clinique, vous pouvez vous attendre à ce qui suit :</p><ul><li>à une évaluation de la santé physique de votre enfant et à des analyses sanguines afin de s’assurer qu’on peut en toute sécurité lui administrer une anesthésie locale, une sédation ou une anesthésie générale;</li><li>à un aperçu de l’intervention et à une revue du formulaire de consentement avec un radiologue d’intervention;</li><li>à une échographie rapide du foie pour localiser le site de la biopsie; on marquera l’abdomen de votre enfant avec un marqueur semi-permanent.</li></ul><p>Dans certains cas, votre enfant pourrait avoir besoin d’être admis à l’hôpital avant de subir une biopsie du foie. Le médecin de votre enfant ou le personnel infirmier vous donnera des instructions précises sur l’endroit où vous devez amener votre enfant avant la biopsie.</p><h3>Consentement avant l’intervention</h3><p>Avant l’intervention, le radiologue d’intervention :</p><ul><li>expliquera le déroulement de l’intervention et pourquoi elle est nécessaire;</li><li>décrira les bienfaits et les risques possibles;</li><li>exposera les mesures qui seront prises pour réduire ces risques;</li><li>vous aidera à évaluer les bienfaits possibles de l’intervention contre tout risque qu’elle peut poser pour votre enfant.</li></ul><p>Signer le formulaire de consentement signifie que vous consentez à l’intervention. Avant de le faire, vous devez comprendre tous les risques et les bienfaits possibles de la biopsie. Assurez-vous d’obtenir des réponses à toutes vos questions. Un parent ou un tuteur légal doit signer le formulaire au nom des enfants qui ne sont pas en mesure de donner leur consentement.</p><p>L’intervention ne sera pas pratiquée sans votre consentement.</p><h3>Comment préparer votre enfant à subir l’intervention</h3><p>Vous devez parler à votre enfant de ce qui va se passer avant tout traitement. Les enfants sont moins anxieux et ont moins peur quand ils savent à quoi s’attendre. Les enfants sont aussi moins inquiets quand leurs parents sont calmes et démontrent leur soutien.</p><p>Lorsque vous parlez à votre enfant, utilisez des termes qu’il peut comprendre. Dites-lui qu’il recevra des médicaments qui l’aideront à se sentir à l’aise pendant l’intervention.</p><h3>Si votre enfant devient malade dans les deux jours précédant la biopsie</h3><p>Pour sa propre sécurité, il est important que votre enfant soit en bonne santé le jour de l’intervention. Si votre enfant commence à se sentir malade ou a une fièvre dans les deux jours précédant la biopsie, prévenez votre médecin. Il se peut que son intervention doive être reportée.</p><h3>Aliments, boissons et médicaments avant l’intervention</h3><p>L’estomac de votre enfant doit être vide au moment de l’administration du sédatif ou de l’anesthésie générale. Donc, le jour de la biopsie, votre enfant devra <a href="http://www.sickkids.ca/VisitingSickKids/Coming-for-surgery/Eating-guidelines/index.html">jeûner</a> (arrêter de manger et de boire) plusieurs heures avant l’intervention. La période de jeûne est fonction du régime alimentaire de votre enfant et du type d’aliments et de boissons consommés. L’équipe de soins de santé de votre enfant vous donnera des instructions précises concernant le jeûne. Veuillez respecter avec diligence ces directives, car il est dangereux pour votre enfant d’avoir une sédation ou une anesthésie s’il a bu ou mangé quelque chose trop près du moment de l’intervention.</p><p>Si votre enfant a des besoins particuliers pendant le jeûne, demandez à votre médecin d'établir un plan.</p><p>Votre enfant peut prendre ses médicaments habituels du matin avec une gorgée d’eau jusqu’à deux heures avant l’intervention.</p><p>Les médicaments tels que l’<a href="/Article?contentid=77&language=French">acide acétylsalicylique (AAS)</a>, le <a href="/Article?contentid=198&language=French">naproxène</a>, l'<a href="/Article?contentid=153&language=French">ibuprofène</a>, le <a href="/Article?contentid=265&language=French">warfarine</a> ou l'<a href="/Article?contentid=129&language=French">énoxaparine</a> augmentent le risque de saignement. Si votre enfant prend un de ces médicaments, discutez-en avec votre médecin et le radiologue d’intervention afin qu’ils vous disent quoi faire. </p>​​<h2>À SickKids</h2> <p>Un jour ou deux avant l’intervention, le radiologue et son équipe évalueront votre enfant dans le département de la thérapie guidée par l’image.</p> <p>Le jour de la biopsie, le personnel de SickKids vous demande de vous présenter à l’hôpital deux heures avant l’intervention.</p>

 

 

Liver biopsy2453.00000000000Liver biopsyLiver biopsyLEnglishOtherChild (0-12 years);Teen (13-18 years)LiverLiverTestsCaregivers Adult (19+)NA2016-04-05T04:00:00ZMichelle Côté, BScN, RN;Constance O’Connor, RN(EC), NP8.0000000000000063.00000000000001747.00000000000Health (A-Z) - ProcedureHealth A-Z<p>Learn what a liver biopsy is, why it is required and how to prepare your child for the procedure.</p><h2>What is a liver biopsy?</h2><p>A liver biopsy is a procedure done to obtain a small sample of the liver so it can be examined under a microscope. A liver biopsy can help your child’s doctor identify problems in the liver, find the cause of liver disease, and/or determine how much damage is in the liver.</p> <figure><span class="asset-image-title"></span><span class="asset-image-title"></span><span class="asset-image-title">Liver</span><img src="https://assets.aboutkidshealth.ca/akhassets/IMD_liver_EN.jpg" alt="" /><figcaption class="asset-image-caption">The</figcaption><figcaption class="asset-image-caption"></figcaption><figcaption class="asset-image-caption"> liver is an organ that is part of our digestive system. It helps us get rid of toxins, digest food, and store energy from food.</figcaption> </figure> <h3>What is the liver?</h3><p>The <a href="/Article?contentid=1468&language=English">liver</a> is an organ in our belly (abdomen). It helps our bodies remove toxins and waste. It also stores some of the energy we get from food and also helps with food digestion by producing bile fluids. The bile helps with digestion of fat from food.</p><h2>Key points</h2> <ul> <li>A liver biopsy is a procedure during which a tiny piece (sample) of the liver is obtained and examined under a microscope.</li> <li>Liver biopsy may help identify problems in the liver.</li> <li>Liver biopsy is carried out at the hospital. Your child will be closely monitored before being sent home when it is safe to do so.</li> <li>Explain to your child using simple words what is going to happen.</li> </ul><h2>How soon after biopsy will results from the test be available? </h2> <p>Results are usually available within a week but some special tests may take longer. Please discuss with your doctor or nurse when to expect your child’s results. Your referring doctor will receive the results of your child's biopsy. You will need to make a follow-up appointment with them to discuss the results.</p><h2>On the day of the liver biopsy </h2><p>Arrive at the hospital well before the planned time of your child’s procedure. Follow your hospital’s directives.</p><p>There, your child will be dressed in a hospital gown, weighed and a nurse will make sure your child is healthy enough to have the procedure.</p><p>You will also be able to speak to the interventional radiologist who will be doing the liver biopsy, and the nurse or anaesthetist who will be giving your child anaesthetic or sedation.</p><p> During the liver biopsy you will be asked to wait in a waiting room. </p><h2>Your child will have medicine for pain </h2><p>Children are given medicine for treatments that may be frightening, uncomfortable, or painful. This includes local anaesthesia, sedation or general anaesthesia. The type of medicine that your child will have for the procedure will depend on your child’s condition.</p><p>Feel free to discuss your questions or concerns with your health-care team.</p><h2>How is a liver biopsy performed?</h2><p>Your child’s doctor will discuss with you the best way for your child to have a liver biopsy before arranging the procedure. The approach to your child’s liver biopsy will be determined by a number of factors, including how well your child feels and the type of liver problem that the doctor suspects.</p><p>The procedure usually takes about one hour.</p><h3>Anaesthesia</h3><p>Right before the procedure, your child will receive a local anaesthesia (“freezing”). This means that only a specific, limited area of your child’s abdomen (belly) will be numbed so they will not feel pain from the biopsy. They may also receive <a href="/Article?contentid=1260&language=English">sedation</a> or <a href="/Article?contentid=1261&language=English">general anaesthesia</a>, which will make your child sleep or feel sleepy throughout the procedure and prevent them from feeling pain during the biopsy.</p><h3>Image guided procedure</h3><p>In most cases, a specialized doctor called an interventional radiologist carries out the liver biopsy using image guidance. The interventional radiologist uses an <a href="/Article?contentid=1290&language=English">ultrasound</a> machine to precisely locate the liver and help identify the biopsy site.</p><p>After cleaning the skin, the radiologist inserts a hollow needle through the skin into the liver and then the biopsy device is inserted into the hollow needle and quickly withdrawn. This removes a tiny liver sample. The radiologist usually takes two to three samples, by re-inserting the biopsy device through the needle. The samples will then be sent to the lab for examination under a microscope.</p><p>The small hole made by the needle may bleed. The doctor puts a small plug in to stop the bleeding. The plug does not need to be removed; it will disappear on its own. A small bandage will be placed over the biopsy site. No stitches are needed. </p><h3>Other image-guided biopsy procedures</h3><p>In some special cases, like such as when children have blood clotting problems or fluid in their belly, doctors will instead do a transvenous liver biopsy. This is done by inserting a small tube through a vein in your child’s neck and pushing it all the way to your child’s liver to take a small sample of liver tissue. This procedure limits the risk of bleeding.</p><h2>After the procedure </h2><p>After the liver biopsy is complete, the interventional radiologist will talk to you about the details of the procedure. Your child will be moved to the recovery area. As soon as your child starts to wake up, a nurse will come and get you so you can be with them.</p><p>Your child will be monitored closely until they can safely go home. The time of discharge is usually between six and 24 hours. It differs depending on the age and health of the child, and the reason for the biopsy.</p><p>Your child will have a blood test about six hours after the biopsy to check any changes in <a href="/Article?contentid=1541&language=English">blood counts</a> and make sure the liver is not bleeding. An ultrasound scan may be ordered. Your child may have to stay on bed rest or be admitted overnight for further observation if your doctor feels it necessary. </p><h2>Going home </h2><p>Most children older than one year of age who have a liver biopsy go home the same day. </p><p>Babies under one year of age and children who are or become unwell may need to be admitted to hospital after the procedure.</p><p>Follow your health-care team’s instructions to <a href="/Article?contentid=1239&language=English">care for your child at home</a>.</p><h2>How to prepare for liver biopsy</h2><h3>Clinic visit to prepare for liver biopsy (pre-procedure appointment) </h3><p>The radiologist and their team will see most children for assessment a day or two before the procedure. During the clinic visit you should expect:</p><ul><li>a physical health assessment and blood work to make sure that your child is healthy and that it is safe to have local anaesthesia, sedation or general anaesthesia</li><li>an overview of the procedure, and a review of the consent form with an interventional radiologist</li><li>a quick ultrasound of the liver to locate the biopsy site; it will be then marked with a semi-permanent marker on your child's abdomen.</li></ul><p>In some cases, your child may need to be admitted to hospital before having a liver biopsy. Your child’s doctor or nurse will give you specific instructions about where you need to take your child before the liver biopsy.</p><h3>Giving consent before the procedure</h3><p>Before the procedure, the interventional radiologist will:</p><ul><li>explain how and why the procedure is done</li><li>the potential benefits and risks</li><li>discuss what will be done to reduce these risks</li><li>help you weigh the potential benefit of the procedure against any risk it may pose for your child. </li></ul><p>Signing the consent form means you agree to the procedure. Before you do so you should understand all the risks and potential benefits of the liver biopsy. Make sure you get answers to all your questions. A parent or legal guardian must sign the consent form for children who are not able to give consent.</p><p>The procedure will not be performed unless you give your consent. </p><h3>How to prepare your child for the procedure</h3><p>You should talk to your child about what will happen before any treatment. Children feel less anxious and scared when they know what to expect. Children also feel less worried when they see their parents are calm and supportive. </p><p>When talking to your child, use words they can understand. Let your child know that they will receive medicines to make them feel comfortable during the procedure. </p><h3>If your child becomes ill within two days before the procedure </h3><p>For their own safety, it is important that your child is healthy on the day of the procedure. If your child starts to feel unwell or has a fever within two days before the liver biopsy, let your doctor know. Your child’s procedure may need to be rebooked.</p><h3>Food, drink and medicines before the procedure </h3><p>Your child’s stomach must be empty before sedation or general anaesthetic. Thus on the day of the liver biopsy, your child will have to fast (stop eating and drinking) several hours before the procedure. The length of time required for <a href="http://www.sickkids.ca/VisitingSickKids/Coming-for-surgery/Eating-guidelines/index.html">fasting</a> will depend on your child’s diet and the type of food and drink consumed. Your child’s health-care team will give you specific instructions about fasting.</p><p>Please follow the fasting guidelines carefully because it is unsafe for your child to have sedation or anaesthesia if they have eaten or had anything to drink too close to the procedure time.</p><p>If your child has special needs during fasting, talk to your doctor to make a plan.</p><p>Your child can take their regular morning medicine with a sip of water up to two hours before the procedure. </p><p>Medicines such as <a href="/Article?contentid=77&language=English">acetylsalicylic acid (ASA)</a>, <a href="/Article?contentid=198&language=English">naproxen</a>, <a href="/Article?contentid=153&language=English">ibuprofen</a>, <a href="/Article?contentid=265&language=English">warfarin</a>, or <a href="/Article?contentid=129&language=English">enoxaparin</a> may increase the risk of bleeding. If your child is taking any of these medicines, please discuss this with your doctor and the interventional radiologist to make a plan for the time of the procedure. </p><h2>What are the risks of a liver biopsy? </h2><p>Liver biopsy is considered a safe procedure with only small risks, which include:</p><ul><li>tenderness and/or mild pain at the biopsy site</li><li>bleeding in the liver</li><li>injury to another organ close to the liver (<a href="https://pie.med.utoronto.ca/htbw/module.html?module=lung-child">lung</a> or gallbladder)</li><li>problems with sedation or anaesthesia (please let you doctor or nurse know if your child has ever had problems with any type of anaesthesia before)</li><li>infection at the biopsy site or in the abdomen</li><li>leaking of <a href="/Article?contentid=1468&language=English">bile</a> fluid</li><li>abnormal connection between arteries and veins in the liver as a result of the healing process after biopsy.</li></ul><p>Risks vary depending on your child’s condition, age and health. You should discuss any concerns you may have with your health-care provider.</p><p>Some medications, diet supplements or herbs may increase the risk of bleeding from liver biopsy. Please discuss all medications, supplements, and herbs that your child is taking with your doctor or nurse. If you are unsure, bring all of your child’s medication, supplements, and herbs—even from over-the-counter—with you at your pre-procedure appointment.</p>​​<h2>At SickKids</h2> <p>The radiologist and their team will assess your child in the Image Guided Therapy department a day or two before the procedure.</p> <p>On the day of the liver biopsy, SickKids’ staff asks that you come two hours before the procedure.</p>https://assets.aboutkidshealth.ca/akhassets/IMD_liver_EN.jpgLiver biopsy

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