Liver Biopsies in the U.K.
from John B.

I read with interest your article, My Liver Biopsy.  It's funny how things can differ in different countries. 

In the U.K., after the procedure, you were not allowed to move for 24 hours, hence you were kept in hospital overnight. On my first biopsy they did not tell me this, hence I drank as many cups of tea and coffee as they were prepared to offer me. The night nurse agreed to allow me to sit on the bed to use the bottles [in-bed urine collection containers for men -Ed].  She wisely brought me 2 bottles.  In those days they were glass and a bit bigger than the ones they use now. I proceeded to fill both but they were not enough.  Fortunately the ward sink was by my bed, so the first 2 were deposited down there then I filled another one. Great at information aren't they!

Over the years I have had 3 liver biopsies.  The first 2 were ok but the 3rd was done by a butcher who did not complete the procedure and left the bed and me covered in blood. I refused to have anymore after that. Fortunately they have ceased to do them in the U.K. They use a new blood test.  Regards  -John B.

*****

Ed’s Response:  Your story aptly illustrates not just how medical practices differ between countries, but also how things change over time.  In the 1990s, in the U.S., we experienced something of a revolution in out-patient versus in-patient practices.  We have a new type of facility often called “surgery centers” that specialize is invasive procedures for which the patient can walk in and walk out on the same day.  So-called “out-patient units” in hospitals provide the same service.  (The facility described in my article, My Liver Biopsy, is a hospital out-patient unit.)  I presume this revolution was motivated in part by an attempt to contain health care costs.  I don’t know how well that’s been established; however, I do know that even the out-patient surgeries are very expensive, often involving separate bills from facility, surgeon, anesthesiologist, labs and pharmacy.

Had my experience been like your third liver biopsy — during which you experienced so much bleeding — I think I’d do my utmost to avoid more of them, too.

I had heard rumors about the blood test to replace liver biopsies.  In fact, before my derm scheduled my biopsy, he went to one of his doctors-only online chat groups and inquired.  Now that it’s accepted practice in the U.K., perhaps it will be accepted in the U.S. soon.  I hope so.

Thanks for this and do stay in touch, John.  –Ed

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