Key takeaways

  • A pancreatic biopsy is a diagnostic test for pancreatic cancer. It involves taking a sample of cells from tissue or a tumor in the pancreas and sending it for laboratory analysis.
  • Types of biopsy for pancreatic cancer include endoscopic biopsy, percutaneous biopsy, and surgical biopsy. Fine needle aspiration (FNA) with endoscopic ultrasound (EUS-FNA) is the most common type of pancreatic biopsy.
  • Possible complications of a pancreatic biopsy include excessive bleeding, infection, acute pancreatitis, and a hole in the small intestine. A medical professional can advise on the risk of complications and ways to manage any that develop.

A pancreatic biopsy can help diagnose cancer within the 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 pancreatic biopsy is generally a safe procedure, but it does come with some risks of complications, such as bleeding and infection.

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

The American Cancer Society estimates that about 67,440 people in the United States will receive a pancreatic cancer diagnosis in 2025. 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. In most cases today, pancreatic biopsies involve 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 medical professional passes a long flexible tube with a camera down your throat and into the 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

During a percutaneous biopsy, a medical professional uses images from an ultrasound or computed tomography (CT) scan to guide a thin needle through the skin and into the pancreas.

Surgical biopsy

Pancreatic biopsies were typically surgical, but now it’s uncommon. Surgical biopsies are usually more suitable when the cancer may have spread beyond the pancreas and a medical professional wants to examine or biopsy other organs as well.

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

A doctor will provide specific instructions to follow before the procedure to lower the 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 activities at least 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 or an anesthetic to help you stay relaxed.
  2. You’ll lie on the examination table, and your doctor will feed the endoscope down your throat and through your stomach and small intestines.
  3. Your doctor will then use an ultrasound to find the tumor.
  4. They’ll take a small tissue sample using a thin needle on the endoscope.

You’ll likely need to stay at the hospital for a few hours after a pancreatic biopsy 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 advisable that you spend the rest of the day at home resting.

Most people return to their usual activities the next day. If you receive an endoscope, you may have a sore throat for around 24 hours.

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

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

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

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

Bleeding is reported in under 2% of people who undergo endoscopic fine needle aspiration. It 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 up 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 studies.

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

  • excessive bleeding
  • cutting a hole in your small intestines
  • infection
  • acute pancreatitis, or sudden inflammation of your pancreas

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% required 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%.

Rest is important after your procedure to give your body a chance to recover. If complications such as bleeding or infection occur, it is important to let your doctor or surgeon know right away. They can advise on treatments to help manage the complications.

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 necessary to confirm a cancer diagnosis. Fine needle aspiration (FNA) with endoscopic ultrasound (EUS-FNA) is the gold standard procedure.

During EUS-FNA, doctors insert a thin tube down the throat with an ultrasound that can produce a picture of the digestive tract and a needle to take a tissue sample.

Pancreatic biopsies are usually safe, but there’s a small risk of complications, such as infection and bleeding. Death is rare, and is usually related to severe bleeding.

Your doctor can give you more information about what to expect from your specific procedure, as well as instructions on how to prepare before and what to expect afterward.