Pre-surgical biopsy is usually not recommended for resectable cholangiocarcinoma; however, pathological diagnosis is very important for the treatment of cholangiocarcinoma, and it is usually performed on the resected tissues after surgery. Pathologic diagnosis of bile duct cancer is very important for the choice of disease treatment plan, but the pre-surgical examination of bile duct cancer, especially for bile duct cancer that can be radically resected, is mainly imaging examination as well as blood laboratory examination. It is difficult to perform puncture biopsy on bile duct tumor tissue before surgery, and there is a risk of tumor planting and metastasis, so it is not recommended to perform biopsy before surgery. However, it is not true that bile duct cancer is not subject to pathological examination. Pathological examination of bile duct cancer mainly involves pathological histological examination of resected tissues after surgery, which helps clinicians to formulate individualized treatment plans and judge prognosis by analyzing pathological factors affecting prognosis such as surgical margins, histological types and grades. It is recommended to cooperate with clinicians to arrange whether and when biopsy is needed for cholangiocarcinoma.