Name of the Procedure:

Biopsy of the Pancreas, Percutaneous Needle
Common name(s): Pancreatic needle biopsy
Medical term: Percutaneous needle biopsy of the pancreas

Summary

A pancreatic needle biopsy is a medical procedure in which a small needle is inserted through the skin to collect a tissue sample from the pancreas. This procedure helps diagnose pancreatic diseases, such as cancer or pancreatitis.

Purpose

The biopsy is used to diagnose or rule out conditions affecting the pancreas. Goals include identifying the presence of tumors, inflammation, or other abnormalities, thereby guiding further treatment or management strategies.

Indications

• Persistent abdominal pain
• Unexplained weight loss
• Jaundice (yellowish skin or eyes)
• Suspicious masses or lesions detected on imaging studies (e.g., CT scans, MRIs)
• Elevated pancreatic enzyme levels

Preparation

• The patient may need to fast for 6-8 hours before the procedure.
• Blood tests may be required to check for any clotting issues.
• Patients should inform their doctor about any medications they are taking, as certain blood thinners might need to be adjusted.

Procedure Description

1. Preparation: The patient lies on an examination table, and the skin over the biopsy area is cleaned.
2. Anesthesia: Local anesthetic is applied to numb the skin and deeper tissues.
3. Imaging Guidance: Ultrasound or CT scan is used to precisely locate the area in the pancreas from which the sample will be taken.
4. Needle Insertion: A thin, hollow needle is inserted through the skin and guided into the pancreas.
5. Sample Collection: Small tissue samples are collected through the needle.
6. Completion: The needle is removed, and pressure is applied to the puncture site to prevent bleeding. A small bandage is placed over the area.

Duration

The procedure typically takes about 30 minutes to 1 hour.

Setting

Performed in a hospital, outpatient clinic, or surgical center with imaging capabilities.

Personnel

• Interventional radiologist or gastroenterologist
• Nurses
• Radiology technician
• Anesthesiologist or nurse anesthetist (if sedation is needed)

Risks and Complications

• Infection at the biopsy site
• Bleeding or hematoma formation
• Injury to surrounding organs or structures
• Pancreatitis (inflammation of the pancreas)
• Allergic reactions to anesthetic

Benefits

• Accurate diagnosis of pancreatic conditions
• Essential information for planning treatment
• Minimally invasive with a relatively quick recovery time

Recovery

• Patients typically observed for a few hours post-procedure.
• Instructions may include rest and avoiding strenuous activity for 24-48 hours.
• Pain at the biopsy site can be managed with over-the-counter pain relievers.
• Follow-up appointments may be necessary to discuss biopsy results and next steps.

Alternatives

• Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA)
• Surgical biopsy
• Imaging studies alone (e.g., MRI, CT scan)
• Each alternative carries its pros and cons, such as varying levels of invasiveness, accuracy, and recovery times.

Patient Experience

During the procedure, patients may feel pressure or discomfort at the biopsy site. Post-procedure, mild pain or tenderness at the biopsy site is common but can be managed with pain relief measures. Most patients can resume normal activities within a couple of days.