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About Pancreatic Biopsy

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What is Pancreatic biopsy?
Pancreatic biopsy refers to the procedure in which some tissue from an unidentified cyst is extracted from the pancreas and examined to find out the presence of cancer. It helps the doctor in accurate diagnosis. Therefore it is imperative that a conclusive tissue sample is obtained from the pancreas during the biopsy. The shape, size and the position of the cancerous tissue cells extracted in a pancreatic biopsy will determine the category and stage of the pancreatic cancer.

What are the available methods of pancreatic biopsy?
There are many methods by which pancreatic biopsy are carried out. The method that your doctor may use will depend on the placement of the cancerous cyst. The following methods are used for exact diagnosis:

• Fine Needle Aspiration (FNA)
  Fine Needle Aspiration (FNA) is the most widely used method of biopsy. FNA biopsy can be carried out in two ways:
  • Percutaneous Approach
    A local anesthetic is applied to your skin from where a needle is inserted. The needle is long and thin and passes through the abdominal wall before reaching the pancreas. A CT scan or an ultrasound guides the needle to the location from where the tumor cells are removed.
  • EUS Guided Approach
    Live ultrasound images are used in the EUS guided approach to guide the needle which is placed through the endoscope into the timorous mass. This is the most frequently used approach for pancreatic biopsy. It is painless and gives accurate results.
• ERCP Brush Biopsy
  You may receive sedatives before this procedure, and an anesthetic spray is used to numb your throat. A small brush is attached to the endoscope which is inserted during an Endoscopic Retrograde Cholangio Pancreatography (ERCP). It goes directly to the bile or pancreatic duct. The brush collects the cells that are examined using a microscope. However, this method has low chances to produce accurate results and conclusive diagnosis.
• Laparoscopic Biopsy
  In a laparoscopic biopsy a laparoscope is used, which is a long flexible endoscopic tube with a camera and light attached to it. It is a surgery in which small incisions are made in the abdomen through with the laparoscope and other tools are inserted through the incisions to remove tissues from the pancreas. Images of the pancreas are transmitted from the laparoscope to a monitor for the doctor to view and operate the procedure.

• Before the procedure you should inform the doctor about your health conditions and concerns such as:
  • Allergies to certain drugs
  • Medications that you may be taking
  • Bleeding problems
  • Pregnancy
  • Heart or lung disease
• You may be required to stop certain medication a week before the procedure if it is advised by your doctor.
• Your stomach may need to be empty for certain biopsy methods such as ERCP.
• You may need to have some medical tests before the biopsy.

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