LIVER BIOPSY

LIVER BIOPSY – Definition, Purpose, Indication, Contraindication, General Instruction, Preliminary Assessment, Preparation of Patient and Environment, Articles Needed, Procedure, After Care and Complication

DEFINITION

It is the removal of a bit of liver tissue particularly for histological examination.

PURPOSE

  • Diagnostic pour pose
  • Morphologic studies
  • Biochemical studies
  • Bacteriologic studies
  • Immunologic studies
  • To get information regarding progression of disease
  • Response to therapy

INDICATION

  • Cirrhosis of liver
  • Hepatic malignancies
  • Granulomas
  • Reticuloendothelial disease, e.g. leukemia

CONTRAINDICATION

  • Bleeding disorders e.g. thrombocytopenia
  • Infection in liver, peritoneum, biliary
  • Severe form of hepatocellular jaundice
  • Gross ascites
  • Suspected hemangioma of liver

Site: needle is inserted at eighth and ninth intercostal space

Position:

  • Position the patient on the right side near to the edge of bed
  • After procedure, position patient supine

GENERAL INSTRUCTION

  • Aseptic technique to be followed
  • Investigate clotting time, bleeding time and prothrombin time
  • Explain the need of procedure in a simple way
  • Watch for complications during and after the procedure
  • Keep two units of blood available for emergency care
  • After procedure, patient should take 24 hour strict bed rest

PRELIMINARY ASSESSMENT

  • Check the doctors order for specific instructions
  • Check age, sex, name and diagnosis of patient
  • Check investigation report from laboratory
  • Check patient’s ability to obey orders
  • Check patient’s self-care ability
  • Check if all articles are available in the unit

PREPARATION OF PATIENT AND ENVIRONMENT

  • Explain the procedure to minimize fear and anxiety
  • Provide privacy
  • Position the patient
  • Teach the patient breathing exclusive
  • Vitamin K is injected to prevent hemorrhage
  • Informed consent is obtained from the patient
  • Shave the area and clean it with antiseptic agent
  • Arrange articles at bedside
  • Monitor vitals before, during and after the procedure
  • Maintain NPO, hours before procedure

ARTICLES NEEDED

An unsterile tray:

  • Solutions – surgical spirit, Tr. Benzoin, iodine
  • Mackintosh with towel
  • K-basin
  • Paper bag
  • Xylocaine 2%

Sterile Tray Containing the Following

  • Formalin 10% solution in a container
  • Sponge holding forceps
  • Dissecting forceps
  • Small 2 bowls to receive solutions
  • Keep patient NPO for 4 hours
  • Wash hands thoroughly
  • Recording and reporting
  • Documentation

COMPLICATION

  • Pain due to irritation of liver cells
  • Hemorrhage
  • Damage to neighboring organs
  • Peritonitis
  • Infection to the needle site
  • Shock
  • Pneumothorax
LIVER BIOPSY – Definition, Purpose, Indication, Contraindication, General Instruction, Preliminary Assessment, Preparation of Patient and Environment, Articles Needed, Procedure, After Care and Complication
LIVER BIOPSY – Definition, Purpose, Indication, Contraindication, General Instruction, Preliminary Assessment, Preparation of Patient and Environment, Articles Needed, Procedure, After Care and Complication

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