A pancreatic biopsy is one test used to diagnose cancer within your pancreas. This procedure involves removing a small sample of cells from a tumor for lab analysis. It can help doctors figure out if a pancreatic tumor is cancerous and determine what type of cancer it is.

A biopsy is usually needed to confirm a pancreatic cancer diagnosis unless your doctor is very confident it’s cancer and surgically removable. It’s usually a safe procedure, but it does come with some risks, including serious bleeding

This article will take a deeper look at what to expect during a pancreatic biopsy and potential complications.

The American Cancer Society estimates that about 62,210 people in the United States will be diagnosed with pancreatic cancer in 2022. Doctors use a combination of tests to diagnose pancreatic cancer, including imaging, blood tests, and biopsies.

A pancreatic biopsy is a procedure where a surgeon removes a small amount of pancreatic tissue to determine if a tumor is cancerous. Most pancreatic biopsies today are performed with nonsurgical methods.

Here’s a look at the most common techniques.

Endoscopic biopsy

An endoscopic biopsy with ultrasound and fine needle aspiration (EUS-FNA) is the current standard of care for diagnosing pancreatic tumors.

During this procedure, a doctor passes a long flexible tube with a camera down your throat and into your small intestines. This tube is called an endoscope.

Doctors then use ultrasound to help guide the endoscope to the correct location and take a small tissue sample with a thin needle.

Percutaneous biopsy

A percutaneous biopsy is performed through your skin. During this procedure, your doctor uses images from an ultrasound or computed tomography (CT) scan to guide a thin needle through your skin and into your pancreas.

Surgical biopsy

Pancreatic biopsies used to always be performed surgically, but now it’s uncommon. Surgical biopsies are usually performed when it’s thought your cancer may have spread beyond your pancreas and a doctor wants to examine or biopsy other organs as well.

The most common procedure is called laparoscopy or keyhole surgery. During this procedure, a doctor makes a small cut in your abdomen and inserts a thin tube called a laparoscope that contains a light and camera.

A doctor will give you specific instructions to follow before your procedure to lower your chances of complications. It’s important to tell them about any allergies you have or medications you’re currently taking.

Your doctor may ask you to stop taking medications that impair your blood clotting or interact with sedatives. They’ll also likely ask you to stop the following 8 hours before your procedure:

  • smoking
  • drinking
  • eating
  • chewing gum

Your exact procedure will vary depending on what type of biopsy you receive. Here’s an idea of what you can expect for an EUS-FNA.

  1. You’ll receive a sedative through an intravenous (IV) line in your arm to help you stay relaxed.
  2. You’ll be given a liquid or spray anesthetic to numb your throat and keep you from gagging. Some people may receive general anesthesia and remain unconscious through the procedure.
  3. You’ll lie on the examination table, and your doctor will feed the endoscope down your throat and through your stomach and small intestines.
  4. Your doctor will then use an ultrasound to find the tumor.
  5. They’ll take a small tissue sample using a thin needle on the endoscope.

The major risks associated with endoscopic ultrasound-guided needle aspiration are:

Complication rates vary between studies and types of biopsies but generally fall into the range of 0% to 2.5%. In a 2022 review of studies, researchers found that 4.7% of people in a group of 723 were hospitalized after EUS-FNB, but only 0.2% needed active treatment.

Needle tract seeding is another potential complication that has been reported. Needle tract seeding refers to the spread and implantation of cancer cells in other tissues. The risk during fine needle aspiration has been estimated between 0.003% and 0.009%.

Pancreatic biopsies are generally considered safe and have low rates of complications.

Bleeding is reported in less than 2% of people who undergo endoscopic fine needle aspiration and is usually minor and resolves by itself. Endoscopic hemostasis, where an endoscope is used to stop the bleeding, and blood transfusions are only required in 0% to 0.44% of cases.

There’s a very small risk of death, with studies reporting rates between approximately 0.1% and 0.8%. Death is usually related to bleeding, according to the studies.

EUS-FNA has become the gold standard for diagnosing pancreatic tumors. Studies have reported the accuracy of EUS-FNA from 77% to 95%. The accuracy has been improving in recent years due to improvements in technology.

In the 2022 study above, researchers found that the EUS-FNA was 85.6% accurate for cancerous samples and 88.3% for noncancerous.

You’ll likely need to stay at the hospital for a few hours after your procedure until your sedative wears off. You won’t be able to drive after your procedure, so it’s important to have a drive arranged in advance. It’s usually recommended that you spend the rest of the day at home resting.

Most people return to their normal activities within a couple of days. If you received an endoscope, you may have a sore throat for 1 or 2 days.

Most people receive the results of their biopsy within a few days to weeks. In some cases, results may be available right away.

Rest is important after your procedure to give your body a chance to recover.

You can use an over-the-counter pain-relieving spray the day after your procedure if you have a sore throat. Alternatively, you can try cough drops or gargling warm salty water.

It’s usually recommended to drink plenty of fluids after your procedure.

Some complications require emergency medical attention. It’s important to contact a doctor or local emergency services if you develop any of the following emergency symptoms after your procedure:

A pancreatic biopsy is usually needed to confirm a cancer diagnosis. EUS-FNA is the gold standard procedure. During EUS-FNA, doctors insert a thin tube down your throat with an ultrasound that can produce a picture of your digestive tract and a needle to take a tissue sample.

Pancreatic biopsies are usually safe, but there’s a small risk of complications. Death is rare, but when it happens, it’s usually related to severe bleeding. Your doctor can give your more information about what to expect from your specific procedure.