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Laparoscopic Liver Biopsy

      I was diagnosed with HepC in March 1998 with a viral count load in the mid-range. I probably contracted HepC during a blood transfusion in 1974 or 1985.  My liver function tests, up till now, have fallen in the normal range.  The symptoms I experience are fatigue and some upper quadrant abdominal pain.  I take the blood thinner Coumadin for a replaced Mitral Valve, so the Doctors' are advising me to put off having a liver biopsy.  I understand their concerns about bleeding but still worry about the presence of cirrhosis.
       My questions:  I have recently read in the local paper about a Doctor who performs liver biopsy using laparoscopic techniques.  Would this be a safer method of biopsy for me?  Wouldn't the Doctor still have to cut out a piece of my liver to examine?  Would the presence of cirrhosis eventually be detected by a change in liver function tests?
       Thank you in advance.
Dear KMK,
No matter what technique (laparoscopic, standard percutaneous approach or CT or ultrasound guided) is used to obtain a liver biopsy (tissue sample), bleeding can occur. Patients on anticoagulants should not have a liver biopsy prior to discontinuation of the drug before the procedure. This has implications in terms of your artificial mitral valve. Chronic hepatitis C viral infection is a slow process. About 20-30% of patients with hepatitis C develop cirrhosis after 20 years of having the infection. Most patients with cirrhosis will have liver function test abnormalities, but the only way to be sure that cirrhosis is present is to perform a liver biopsy. The next question that needs to be answered is what will you do with the information after you have a liver biopsy? Are you considering treatment with interferon? If not, what is the point of have an invasive procedure with potential risks and complications? I hope you find this information helpful.
This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.
If you would like to be seen at our institution please call 1-800-653-6568 our Referring Physicians' Office and make an appointment to see Dr. Moonka, one of our expert Hepatologists.
*Keywords: hepatitis C viral infection, cirrhosis, liver biopsy

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