Liver Biopsy: Is it Worth the Risk? According to the findings of major medical studies involving thousands of patients,
The liver biopsy is an important diagnostic tool for physicians to determine the severity and aggressiveness of hepatitis and other liver diseases. The information gained from this procedure cannot be obtained from other, less invasive tests, including ultrasound (Lindor et al, 1996), and it promotes accuracy in the prediction of the probable outcome of the disease. A doctor will often order a liver biopsy when a blood test shows that the liver enzymes are elevated, especially for longer than several weeks. Liver biopsies are also used to determine if a specific treatment for liver disease has been effective, for instance a-interferon therapy, or if the liver has been adversely affected by other drug therapies that are known to be toxic to the liver. Needle biopsy of the liver is performed after a small incision is made between the ribs over the liver area. A needle is inserted to a depth of less than 2 millimeters, and a small sample of tissue is withdrawn. Afterward the patient is required to lie still for up to three hours to reduce the possibility of internal bleeding (hemorrhage). Needle liver biopsy seems to be safer than laparoscopic liver biopsy, which calls for insertion of an optical instrument into the abdomen (Glaser & Pausch, 1995). As far as the patient's perspective goes, there are problems with liver biopsy. The technique is invasive and usually painful. Complications severe enough to require hospitalization can occur in approximately 4% of patients (Lindor et al, 1996). In a review of over 68,000 patients recovering from liver biopsy, 96% experienced adverse symptoms during the first 24 hours of recovery. Hemorrhage was the most common symptom, but infections also occurred. Side effects of the biopsies included pain, tenderness, internal bleeding, pneumothorax, and rarely, death (Tobkes & Nord, 1995). Sonography used before liver biopsy significantly reduces complications by helping to guide the biopsy needle to an exact location in the liver. In clinical studies, ultrasound was fast (required less than one minute) and definitely demonstrated the ability to reduce complications and hospitalizations after biopsy, as well as increase the reliability of the results [definitive diagnosis made in 99.4% of patients (Caturelli, 1996; Lindor et al, 1996)]. While modern medicine maintains that liver biopsy has its benefits, few if any studies have assessed the procedure's long-term effects. Because the liver is cut and bleeds during biopsy, there will be some subsequent scarring. Can this area act as a focal point for future pathology or in any way interfere with any of the subtle functions of the liver? In any event, biopsy is obviously traumatic and should be used only when absolutely necessary. In a holistic sense, its main benefits may lie in its shock value. If a doctor observes that your liver is 80% destroyed, as one patient recently reported in my clinic, then you will become surprisingly motivated to turn your health around. In considering whether to have a biopsy done, one should remember that modern medicine often does not allow for the healing potential inherent in each individual. A program for liver health includes a diet appropriate for liver stress or disease, plus an effective herbal formula and other dietary supplements such as antioxidants and essential fatty acids. Optimally, this program will cause the liver enzymes to return to a normal range, accompanied by a decreased or low viral load. The liver will get better, and a long healthy life can be anticipated. Alternately, the liver may get worse and the quality and length of life be reduced. But will a liver biopsy really change the outcome? < return to intro to next excerpt >
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