Biopsy of liver, wedge
CPT4 code
Name of the Procedure:
Biopsy of liver, wedge
Alternate names: Wedge biopsy of the liver, Surgical liver biopsy
Summary
A wedge biopsy of the liver involves the removal of a small, wedge-shaped piece of liver tissue. This procedure is typically performed during surgery and is used to diagnose liver conditions by examining the tissue under a microscope.
Purpose
The procedure helps diagnose liver diseases, including cirrhosis, hepatitis, and liver cancer. It aims to identify abnormalities in liver tissue that aren't detectable by other diagnostic methods.
Indications
- Abnormal liver function tests: Persistent abnormalities suggest underlying liver disease.
- Liver lesions: Unclear liver lesions identified via imaging techniques.
- Unexplained liver symptoms: Symptoms like jaundice or unexplained weight loss tied to liver function.
Preparation
- Fasting: Patients are usually required to fast for at least 6-8 hours before the procedure.
- Medication adjustments: Patients may need to stop taking certain medications, such as blood thinners, several days before the procedure.
- Pre-procedure tests: Blood tests, imaging studies like ultrasound or CT scan, and a review of medical history are necessary.
Procedure Description
- Anesthesia: The procedure is performed under general anesthesia.
- Incision: A small incision is made in the abdomen to access the liver.
- Tissue removal: A wedge-shaped portion of liver tissue is surgically excised using specialized surgical instruments.
Closure: The incision is closed with sutures or surgical staples.
Tools and equipment: Scalpel, surgical scissors, forceps, retractor, and possibly an ultrasound probe for guidance.
Duration
The procedure typically takes about 30-60 minutes.
Setting
The biopsy is performed in a hospital or a surgical center, often in an operating room.
Personnel
- Surgeon: Performs the biopsy.
- Nurses: Assist during the procedure and provide post-operative care.
- Anesthesiologist: Manages anesthesia and monitors the patient’s vital signs.
Risks and Complications
Common risks include bleeding, infection, and pain at the incision site. Rare complications can include accidental injury to nearby organs and significant blood loss. Proper management involves monitoring and prompt medical intervention if complications arise.
Benefits
The biopsy provides a definitive diagnosis which helps in determining an appropriate treatment plan. The benefits can be observed shortly after the biopsy results are analyzed, providing crucial information on liver health.
Recovery
- Post-procedure care: Patients are monitored in a recovery room until the effects of anesthesia wear off.
- Instructions: Avoid heavy lifting and strenuous activities for at least a week. Keep the incision site clean and dry.
Follow-up: A follow-up appointment is needed to discuss biopsy results and further treatment or care plans.
Alternatives
- Percutaneous liver biopsy: Less invasive but limited by accessibility and the possible need for multiple needle insertions.
- Transjugular liver biopsy: Less invasive, used for patients with bleeding disorders but may yield smaller tissue samples.
Imaging studies: Non-invasive but often less definitive than tissue analysis.
Each alternative has its pros and cons, including the level of invasiveness, accuracy, and specific patient conditions that may dictate the choice.
Patient Experience
Patients will not feel anything during the procedure due to anesthesia but may experience soreness and mild pain afterward, which can be managed with prescribed pain medications. Anxiety and discomfort related to waiting for results are common experiences.