Intraoperative fine needle aspiration cytology in pancreatic lesions.

The notes of 129 patients investigated by intraoperative fine needle aspiration biopsy between 1973 and 1977 have been reviewed. Eighty-four of the patients were operated on and punctured at the Department of Surgery, Lund, and 45 at different county hospitals belonging to the region. All aspirates were stained and evaluated at the Department of Cytodiagnostics, Lund. Sixty-four of the 75 patients with pancreatic cancer were correctly diagnosed and in another three patients the cytological diagnosis was "suspicion of cancer." Including these latter cases the sensitivity of the method was 91% in pancreatic cancer. In four out of five patients with endocrine tumors the cytological report was correct i.e., "endocrine tumor." In none of 22 patients with chronic pancreatitis or pancreatic cysts the diagnosis was falsely positive. Twenty-seven patients who during the operation were suspected of having a pancreatic lesion were at follow-up (mean 2.8 years) found not to have any significant pancreatic disease. Among these patients no falsely positive reports were given. In nine of the 129 patients (7%) the aspirates even at re-checking were found to be nonrepresentative or the aspiration unsuccessful. Six of these were performed at county hospitals. In 24 patients with pancreatic cancer total pancreatectomy was performed. In the remaining 105 patients no complications which could be related to the puncture were detected.