Cytological Diagnosis of Pancreatic Tumors

Abstract

Until the early 1970s, pre- and intraoperative histological diagnosis of pancreatic tumors was performed by means of wedge biopsies or the Vim-Silvermann needle [1, 5]. Since, however, even in pancreas resection specimens it was often extremely difficult to distinguish between highly differentiated ductal carcinomas and ductal hyperplasias, none of these methods gave the desired accuracy. The ensuing complications were also high (l%–20%); some authors even calculated a 9% mortality rate [4]. Shortly after the first promising reports appeared on the intra-operative cytological dignosis of pancreatic lesions by means of fine-needle biopsies, this method was introduced at the authors’ clinic [3, 6]. Since then, various methods have been presented that enable pancreatic tumors to be localized before surgery [2], thereby making them accessible for fine-needle biopsies (FNBs). Of all these methods, ultrasound-guided puncture is certainly the simplest and the most comfortable for the patient.