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Biopsy - biliary tract

Definition

A biliary tract biopsy is the removal of tissue or substances from the duodenum, bile ducts, pancreas, or pancreatic duct for examination under a microscope.

Alternative Names

Cytology analysis - biliary tract; Biliary tract biopsy

How the test is performed

Your doctor can obtain a sample for a biliary tract biopsy in different ways.

A needle biopsy can be done if you have a well-defined tumor. The biopsy site is cleaned. A thin needle is inserted into the area to be tested, and a sample of cells and fluid are removed. The needle is then removed. Pressure is applied to the biopsy site to stop any bleeding. The site will be covered with a bandage. See also: Aspiration

If you have a narrowing or blockage of the bile or pancreatic ducts, a sample can be taken during procedures such as:

• Endoscopic retrograde cholangiopancreatography (ERCP)
• Percutaneous transhepatic cholangiogram (PTCA)

How to prepare for the test

You may not be able to eat or drink 8-12 hours or more before the test. Your health care provider will give you specific instructions.

Make sure you have someone to drive you home.

How the test will feel

How the test will feel depends on the specific procedure used to remove the tissue or fluid sample for the biopsy.

In general, if you have a needle biopsy, you may feel a sting as the needle is inserted. Some people feel a cramping or pinching sensation during the procedure.

For other biliary tract biopsy methods, you will likely be given medicines to prevent pain and to help you relax.

Why the test is performed

A biliary tract biopsy can determine whether a tumor started in the liver or spread from another location. It also can determine if the tumor is cancerous.

This test may be done:

• After a doctor's examination, x-ray, MRI, CT scan, or ultrasound shows abnormal growths in your biliary tract
• To test for diseases or infection

Normal Values

A normal result means there are no signs of cancer, disease, or infection in the biopsy sample.

What abnormal results mean

Abnormal results may be due to:

• Cancer of the bile ducts (cholangiocarcinoma)
• Cysts in the liver
• Liver cancer
• Pancreatic cancer
• Swelling and scarring of the bile ducts (primary sclerosing cholangitis)

What the risks are

Risks depend on how the biopsy sample was taken.

In general, risks may include:

• Bleeding at the biopsy site
• Infection

References

Afdahl NH. Diseases of the gall bladder and bile ducts. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 159.

Stockland AH, Baron TH. Endoscopic and radiologic treatment of biliary disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 70.