Liver Clinic

Viral hepatitis is well known and wide spread form of liver infection affecting people worldwide. With the viruses ranging from type A to Type E, the 2 common types with long term consequences are Hepatitis B and C. These 2 viruses can result in a chronic infection state such that people infected with them will habour the viruses in their system for decades. With a longer exposure time, these virus can cause greater damages to the liver resulting in liver hardening, also known as liver cirrhosis. By this stage, the affected liver will lose its function gradually before liver failure sets in. Another dreaded consequence of these infections is liver cancer.

The good news is that there are anti-viral agents available in the market which can effectively control the infection or even clear the viruses from the body in some cases. To achieve proper control of the infections, one has to follow the recommended review intervals and undergo regular blood tests during evaluations. Anti-viral treatment may also be prescribed to pregnant ladies, if necessary, to minimise the transmission of Hepatitis virus to their offspring during delivery.

This is consider as one of the most significant disease of the liver. Many primary liver cancer patients have history of chronic liver diseases such as chronic viral hepatitis or alcoholic liver cirrhosis. Such chronic liver conditions predispose one to higher risks of developing cancer in the liver. It is therefore very important to follow closely the recommendations from your specialists on how to manage these conditions to avoid late detection of primary liver cancer.  

At times, liver cancer can also develop as secondaries from another cancer elsewhere. The primary cancer, in this case, may be from the colon or nearby structures such as the bile duct and the cancer cells travel to the liver via blood or lymphatic circulations. Such secondary cancers may be multiple and widespread in the liver and therefore more challenging to treat. It is suffice to say all effort is made to detect such unfortunate developments at the earliest possible stage so that wider treatment options are available which hopefully lead to a better outcome.

A liver biopsy is a procedure that involves getting a small piece of liver tissue for further examination under the microscope. It is usually done to diagnose, evaluate and monitor certain liver conditions such as cirrhosis (scarring of the liver) or inflammation of the liver which can be due to various causes. Liver biopsy is also commonly used to confirm suspicious masses seen under ultrasound or CT scans. Liver biopsy is usually performed through the skin under ultrasound guidance. In very special cases, it can also be done under Endoscopic Ultrasound (EUS) guidance for precise targeting of masses in the liver.

In the external approach, the patients will lie on a couch on their back. The skin over the liver is cleaned with antiseptic. Some local anaesthetic is then injected into a small area of skin and tissues over a part of the liver. A special needle will then be pushed through the skin into the liver and a small sample of liver tissue will be taken. For EUS guided liver biopsy, a special EUS endoscope is used to acquire the tissue from the inside through the wall of the stomach.

Liver biopsy is generally a safe procedure. The most common problem is mild pain at the biopsy site. More serious complications such as bleeding, infection and injury to the nearby organs are rare. It is therefore important for you to speak with your doctor to obtain more information before getting a liver biopsy.