Hepatitis C
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Articles by
Dr. Zhang
 
TCM and MCM Theory Related to Common Liver Disease Blood Test Markers

Low Dose Interferon Patient Experiment

Hepatitis A Prevention Reminder

Hepatitis: Causes of Pain in Liver Region 

The Need to Monitor Your Chronic Hepatitis

Liver Enzyme Fluctuation during Allergy Season 

What are the Serum Markers of Hepatitis B and What do They Mean?

Enterogenous Endotoxemia in Chronic Hepatitis–
Part 2

Enterogenous Endotoxemia in Chronic Hepatitis–
Part 1
 

Chronic Hepatitis and "Blood Activating and Stasis Expelling" (BASE) Therapy -
Part 2

Chronic Hepatitis and "Blood Activating and Stasis Expelling" (BASE) Therapy
Part 1

What Causes Gastrointestinal Bleeding in Cirrhotic Liver Disease

Dietary Support for Cirrhotic Liver Diseases

Ascites - A Complication of De-Compensated Liver Cirrhosis

Liver Cirrhosis - Portal Vein Hypertension Complications

Liver Cirrhosis Overview

PG-IFN and Ribavirin Treatments

Antibiotics and Chronic Liver Diseases

Why is Alcohol Harmful for People with Hepatitis?

Co-infections and Super-infections of Viral Hepatitis

Beware of Medications That Can Cause Liver Damage

Bile Retention and Its Clinical Manifestations (MCM) part 4

Modern Chinese Medicine (MCM) Part 3 
Jaundice and Chronic Viral Hepatitis

Modern Chinese Medicine (MCM) Anti-Liver-Fibrosis Treatments - Part 2

Modern Chinese Medicine (MCM) Anti-Liver-Fibrosis Treatments - Part 1

What is Liver Fibrosis and How is It Different from Cirrhosis?

How does the liver change as we get older?

How is that my LFTs are so good when my viral load is seemly so high?

Comprehensive Care for Chronic Viral Hepatitis

What can Cause Liver Inflammation?  

What Are the Major Functions that the Liver Carries?


 

Liver Biopsy
Procedure

A liver biopsy can usually be safely performed as an outpatient procedure. A physician trained and experienced in the procedure should perform the liver biopsy. Prior to the procedure, patients should discontinue all anticoagulants (e.g., coumadin) for at least a week and should not take aspirin or other non-steroidal anti-inflammatory medicines for about a week (patients can take acetaminophen). Additional contraindications to percutaneous liver biopsy include the following:

Absolute Contraindications
-Uncooperative patient
-History of unexplained
-bleedingTendency to bleed*
-Prothrombin time 3-5 sec more than control
-Platelet count <50,000/mm3
-Prolonged bleeding time (10 minutes)
-Use of NSAID within previous 7-10 days
-Blood for Transfusion unavailable
-Suspected hemangioma or other vascular tumor
-Inability to identify an appropriate site for biopsy by percussion or ultrasonography
-Suspected echinococcal cysts in the liver

Relative Contraindications
-Morbid obesity
-Ascites
-Hemophilia
-Infection in the right pleural cavity or below the right hemidiaphragm

*Although these criteria are considered absolute contra-indications by most hepatologists, they can be corrected by transfusions of platelets or fresh-frozen plasma and are therefore not truly absolute.

SOURCE: Bravo AA, Sheth SG, Chopra S. Current Concepts: Liver Biopsy. N Engl J Medicine 2001; 344: 498, Table 2.; Use of aspirin within 7-10 days is an absolute contraindication to liver biopsy. Use of other NSAIDS within the previous 3 days is generally an absolute contraindication.

For the procedure:

Patients must provide written informed consent.

Patients are placed flat in bed and the liver is localized in the right mid-axillary line. Localization of the liver can be performed by percussion/palpation or by ultrasound. Some physicians administer conscious sedation prior to the liver biopsy.

The skin over the biopsy site is cleaned with betadine or another suitable antiseptic, and lidocaine is injected locally to anesthetize the skin and the capsule of the liver.

Liver biopsy is performed by quickly inserting and then withdrawing a 15 to 18-gauge needle into the liver. A successful biopsy obtains a piece of liver tissue approximately the diameter of the lead in a pencil and 1 inch long

Post-Procedure:

-The patient lies on his/her right side for 1-2 hours and then on his/her back for 3-5 hours (total observation after liver biopsy is 4-6 hours)

-Blood pressure and heart rate are checked frequently during this time

-Patients are allowed to go home if they can follow instructions reliably and have easy access to a hospital should they develop bleeding or other complications

-Patients should remain off anti-coagulants, aspirin and NSAIDs for at least one week

-Patients should be advised to refrain from heavy lifting or strenuous exercise for one to two weeks following the procedure

 

Return Home
About HCV
Overview
Causes and Transmission

 
Diagnostic Tests
Antibody
HCV RIBA
HCV RNA 
Viral Load

Viral Genotyping

 
Major Signs
Liver Inflammation
Fibrosis
Cirrhosis

 
Peripheral Signs and Symptoms
Fatigue
Jaundice
Bile Retention
Joint Pains and Skin Rashes
Blood Sugar Instability
Portal Vein Hypertension
Ascites

 
Important Liver Function Test Markers
Overview
ALT and AST
ALP and GGT
Albumin
Bilirubin
PT (Prothrombin Time)
 
Liver Biopsy
Overview
Procedure
Inflammation Grade
Fibrosis Stage
 
Interferon Based Treatment
Overview
Ideal Candidate
Possible Side-effects
 
Liver Support with TCM
Overview
Liver Enzymes
Serum Albumin
Blood Clotting Factors
Bile metabolism
GGT
 
Dietary Considerations
Overview
Proteins
Essential Fats
Carbohydrates
Vitamins
 
 

 


 

 

Medical Information Sources:
http://www.nih.gov/
http://www.nlm.nih.gov/

http://nccam.nih.gov/
http://www.medlineplus.org/


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