Preoperative preparation for liver biopsy

1. Patient education and informed consent

The patient needs to be adequately prepared before a liver biopsy is performed. Ideally, patient education should begin at the preoperative clinic. The medical staff should explain the surgical procedure in detail to the patient, and pay attention to the treatment of the patient's anxiety and pain.

On the day of biopsy, the recent patient's prothrombin time (PT) and complete blood count (CBC) test results were comprehensively evaluated. The surgical procedure was explained to the patients and their informed consent was obtained.

2. Preoperative planning

Aspirin was discontinued 1 week before surgery. Nonsteroidal anti-inflammatory drugs (NSAIDs) should be discontinued 3 days before biopsy. Patients were or were not asked to fast overnight. Eating before surgery can shrink the gallbladder, reducing the risk of puncturing the gallbladder. However, fasting may reduce the likelihood of nausea and vomiting after surgery.

The American Gastroenterological Association (AGA) recommends 1:

➤ Liver puncture should be completed within 30 minutes

➤ The patient needs to be escorted during the first night after surgery

➤ Patients should not have any contraindications or conditions that increase the risk associated with surgery (eg, severe complications such as encephalopathy, ascites, severe jaundiced liver failure, significant extrahepatic obstruction, major coagulopathy, or severe congestive heart failure)

➤ The facility performing the biopsy should have a nationally accredited blood bank, laboratory, inpatient bed, and nursing staff who can supervise the patient for at least 6 hours postoperatively; however, the American Association for the Study of Liver Diseases (AASLD) recommends a routine observation period of 2- 4 hours2.

➤ If bleeding, bile leak, pneumothorax, or need for more than one dose of analgesic, hospitalization is recommended

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