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MEDICAL ANIMATION TRANSCRIPT: Your doctor may obtain a liver biopsy to determine the cause of liver disease and the extent of the damage. The liver is located in the upper right abdomen just under the diaphragm. It lies almost entirely within the ribcage, which provides some protection to the organ. The liver is critical for digestion and metabolism. Its many functions include producing bile, which is necessary for fat absorption; producing proteins from amino acids; packaging fat for storage or transportation in the blood; regulating blood sugar levels; and processing substances, such as alcohol and drugs. A liver biopsy may be ordered to determine the cause of abnormal liver function tests, swelling or enlargement of the liver, and jaundice, the yellowish discoloration of the skin and white of the eye that develops when the serum bilirubin is elevated. Bilirubin is normally metabolized by the liver. These signs and symptoms may be due to a variety of liver conditions, including cirrhosis, hepatitis, or cancer. Before the procedure, an IV line will be started and you may be given a sedative to help you relax. A liver biopsy is done with local anesthesia so you will be awake during the procedure. You will be asked to lie on your back with your right arm above your head. You will need to lie as still as possible during the procedure. The right lung and gallbladder are close to the liver, and moving could cause damage to these organs. Your doctor will determine the location of your liver by ultrasound or by lightly tapping your abdomen with his or her fingertips. After cleaning the area over the biopsy site with an antiseptic, your doctor will inject a local anesthetic to numb the skin and surface of the liver. Once the skin is numb, your doctor will make a small nick with a surgical blade. This is where the needle will be introduced. Your doctor will carefully advance the biopsy needle to the surface of the liver. Your doctor will then ask you to hold your breath while he or she advances the needle into the liver and obtains the tissue sample. As soon as the biopsy is obtained, you will be able to breathe normally. You may feel a momentary sensation in your right shoulder during or just after the biopsy. Some patients have pain that requires additional medication, which is provided by your doctor if needed. Afterward, pressure will be applied at the site of the biopsy to stop any bleeding, and a bandage will be placed on the incision. You will need to lie on your right side for a minimum of one hour following the biopsy. After the procedure, your blood pressure and heart rate will be closely monitored. After lying on your right side for an hour or two, you'll be asked to lie on your back for a minimum of three additional hours. Liver biopsies are considered outpatient procedures. If there are no complications, you will be discharged four to eight hours after the procedure.