Intrasurgical pancreas cytology

Introduction: A differential therapy of chronic pancreatitis and carcinoma calls for evaluation of the validity of findings. Presurgical suspicion of a carcinoma often requires intrasurgical diagnostics such as excisional biopsies, punch biopsies, and fine-needle aspiration cytology (FNAC) for confirmation. Aims: To evaluate FNAC as an intraoperative diagnostic method of very high probability. Methodology: Intrasurgical fine-needle aspiration biopsy and cytologic assessment were carried out in 474 patients. The indications for operative therapy and FNAC were suspicion of pancreatic tumor, chronic pancreatitis even without suspicion of tumor, and pathologic alterations found during other surgeries in the upper abdomen. Results: The level of sensitivity was 93.1%, specificity was 99.1%, predictive value of positive results was 99.2% and of negative results was 92.1%. Conclusion: FNAC is a suitable method for intrasurgical confirmation of pancreatic carcinoma. It can be performed safely, effectively, and rapidly.