Biopsy of the biliary tract

How the Test is Performed:
The tissue sample can be taken during procedures such as endoscopic retrograde cholangiopancreatography ( ERCP ) or percutaneous transhepatic cholangiogram (PTC).

It can also be obtained through an aspiration needle. If the biopsy is taken through a needle, the puncture site will be anesthetized and the needle inserted through the skin into the lining or tissue to be analyzed. A small amount of tissue is taken in through the needle, and the needle is removed. The puncture site is then covered to control any bleeding . Pressure may be applied to the puncture site if bleeding persists.

If the biopsy is taken during the ERCP, forceps are inserted through the endoscope and the tissue is removed through the scope.

How to Prepare:
Food and fluids are restricted 8 to 12 hours or more before the test. Your health care provider will give you specific instructions. You must sign an informed consent form. Arrange transportation for yourself, because the procedure can induce weakness . Your medical history will be taken and a physical examination performed.

Infants and children:
The physical and psychological preparation you can provide for this or any test or procedure depends on your child's age, interests, previous experience, and level of trust. For specific information regarding how you can prepare your child, see the following topics as they correspond to your child's age:



How it Feels:
If the biopsy is taken through a needle, there will be a slight stinging sensation when a local anesthetic is administered. After the anesthetic takes effect, there may be a cramping or pinching sensation.

If the biopsy is taken during an ERCP , there is some discomfort as the endoscope is inserted. An anesthetic is administered through the scope, so there is minimal discomfort when the biopsy is taken.

Risks:
There is some risk of bleeding from the biopsy site. With the needle biopsy, there is a slight chance of infection at the puncture site. Also see the risks for an ERCP if the biopsy is taken through an endoscope.

Why this Test is Performed:
A biopsy is necessary to distinguish between metastatic and primary tumors and to determine if a growth is malignant.

A biopsy may also be taken:



Normal Values:
Tissue that is not cancerous, diseased, or infected is normal.

Abnormal Results:



Cost:
The cost of a PTC is $1700.

The cost of an ERCP , depending on which biopsies are taken, is $1600 to $2000.

The cost of a pancreatic biopsy is $2500 to $2800.

There are additional costs for the anesthesiologist, second technician, a hospital stay if necessary, and for multiple biopsies.

Special Considerations:
This test is performed after a health history, physical examination , or other tests and procedures have indicated abnormal growths or signs of malignancy or disease.