[Intraoperative diagnosis of pancreatic carcinoma].

Between 1978 and 1981 634 frozen section examinations were performed during 185 operations on patients with pancreatic or periampullary carcinoma. The frozen section findings and the definite reports after paraffin embedding were identical in 97.2% of all examinations. 1.6% of frozen section findings were false negative, 0.2% false positive. The positive predictive value, especially important for the surgeon, was 100% for examinations of the pancreas and the primary tumor and 98.9% for metastases and structures suspicious of metastases. The negative predictive value was 94.3% and 99.6% respectively. Serious complications of pancreatic biopsies were not observed. On 438 pancreatic resection specimens after intraoperative frozen section examination a benign disease was diagnosed between 1971 and 1981. By further work-up after paraffin embedding at another institution a carcinoma was detected surprisingly only in two cases (0.5%). A pancreatic resection based on a false positive frozen section finding was never performed. The results prove that intraoperative frozen section examination is a useful and reliable diagnostic procedure. A review of the recent literature demonstrates as well that similar results cannot be achieved by other methods including intraoperative fine needle aspiration biopsy.