Pancreatic Cancer

Endoscopies and biopsies

Using an endoscope a doctor can look inside the body. An endoscope is a thin, long, flexible tube that contains a light source and a video camera, so that images of the inside of the body can be seen on an external monitor (screen). Endoscopes can be inserted into the body through a natural opening, such as the throat (to look at the oesophagus or gullet and then the stomach an duodenum) or anus (the opening through which stools pass out of the body to look at the rectum and colon).Most people we interviewed had the cause of their symptoms investigated using an endoscope inserted via the throat, although a few had one inserted via the anus (colonoscopy) (see ‘Diagnostic tests for pancreatic cancer).

Endoscopic retrograde cholangio pancreatography (ERCP) allows the doctor to see if a tumour is blocking the bile duct. Using the endoscope the doctor can inject a special dye into the bile and pancreatic ducts. Then an X-ray is taken. The dye shows up on the X-ray, and is intended to show where the bile duct is blocked. An ERCP can take between 30-60 minutes. People usually have a local anaesthetic and a sedative; rarely a general anaesthetic is required. A few people chose not to have a sedative for their first endoscopy but asked for one if the procedure was repeated.

Most people who had an endoscopy hadn’t liked the idea of having to swallow the tube and had found the procedure itself unpleasant - but it hadn’t lasted long. Some of those who had had a sedative had fallen asleep and remembered little about it.

Everyone we interviewed who had an endoscopy via the throat had an ERCP except for one man (Fred - Interview 38) who had a similar procedure called an endoscopic ultrasound (EUS), which involves passing an ultrasound probe down the endoscope to provide ultrasound pictures of the pancreas and surroundings organs.

During an endoscopy the surgeon can do a biopsy. A small instrument attached to the endoscope can collect cells from the suspected tumour to see if they are cancerous.

Doctors sometimes do a biopsy of the pancreas, or a biopsy of another affected organ, using a long, thin needle, which goes through the patient’s abdomen. Ultrasound scans help to guide the needle towards the tumour.

A biopsy may be done in other ways too. Sometimes doctors do a laparoscopy, making one or more small incisions in the abdomen and passing a laparoscope (telescope) through one of them. This allows the doctor to see inside and take the biopsy.

The results of Helen’s first endoscopic biopsy were inconclusive so another one was taken during an operation to remove the tumour.

Some people we interviewed had a stent inserted to relieve jaundice at the same time as having the endoscopy (see ‘Treating the initial symptoms).

Last reviewed June 2015.
Last updated June 2015.

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