Biopsy for bile duct cancer

A biopsy means taking a sample of cells or tissue and looking at it under a microscope. This is the only way to be certain whether a growth is a cancer or not. There are different ways to have a biopsy of the bile ducts. 

Biopsy during an ERCP

ERCP stands for endoscopic retrograde cholangio pancreatography. Your doctor puts a long, flexible tube called an endoscope down your throat to look at your pancreas and bile ducts.

The endoscope has a small camera and light at the end. Your doctor can look down the endoscope or at pictures on a TV monitor. They can take x-rays and samples (biopsies) of any abnormal looking areas.

Biopsy during percutaneous transhepatic cholangiography (PTC)

A percutaneous transhepatic cholangiography (per-kew-tay-nee-us trans-hep-attic col-an-jee-og-raf-ee) is a way of looking at your bile ducts using x-rays. 

Your doctor puts a long thin needle into the right side of your tummy (abdomen) and injects some dye into your bile ducts. The dye shows up any blockages on the x-ray. They can take samples (biopsies) of any abnormal looking areas.

You usually have a PTC if you can't have an endoscopic retrograde cholangio pancreatography (ERCP) for any reason. 

Biopsy using an ultrasound or CT to guide the needle

Your doctor uses an ultrasound or CT scan to look at the bile ducts. You have a local anaesthetic injection in the skin over the area so that it goes numb.

Your doctor uses the scan to guide a fine needle through the skin and into the bile ducts. They attach a syringe to the needle and draw up a sample of cells. This is called a fine needle aspiration (FNA).

Biopsy during keyhole surgery (laparoscopy)

Laparoscopy is a small operation to look inside your tummy (abdomen). Your surgeon can look for any signs of cancer and whether it has spread. You might have it to help your doctor decide if surgery to remove the cancer is possible.  

You have the operation while you are asleep (under general anaesthetic). Your surgeon can take samples of tissue and fluid to send to the laboratory. The samples are checked for cancer cells. 

After your biopsy

Your doctor sends the biopsy samples to the laboratory to be looked at under the microscope. You need to stay in hospital for several hours after a biopsy, or overnight.

Possible risks

Biopsies are usually safe but as with any medical procedure, there are possible risks. Doctors make sure the benefits of the test outweigh these risks.

The possible risks depend on the way you have the biopsy. Your doctor will talk to you about all the possible risks before you have a biopsy. 

Bruising and bleeding

You may have some bleeding and bruising. Bleeding usually stops on its own. In some cases, this can be severe and you will need medicine to stop it and maybe a blood transfusion. 


There's a risk of infection. Contact your doctor if you get a temperature or generally feel unwell. 

Getting your results

You should get your results within 1 or 2 weeks. 

Waiting for results can make you anxious. Ask your doctor or nurse how long it will take to get them. Contact the doctor who arranged the test if you haven’t heard anything after a couple of weeks.

You might have contact details for a specialist nurse who you can contact for information if you need to. It may help to talk to a close friend or relative about how you feel.

For information and support, you can call the Cancer Research UK nurses on freephone 0808 800 4040. The lines are open from 9am to 5pm, Monday to Friday.
Last reviewed: 
07 Oct 2021
Next review due: 
07 Oct 2024
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    SA Khan and others 
    Gut, 2012. Volume 61, Pages 1657-1669

  • Biliary cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow up
    JW Valle and others
    Annals of Oncology, 2016. Volume 27, Pages 28-37

  • Diagnostic approaches for cholangiocarcinoma
    A Weber, RM Schmid and C Prinz 
    World Journal of Gastroenterology, 2008. Vol 14, Issue 26. Pages 4131-4136

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