Ultrasonically guided percutaneous puncture and analysis of aspirated material of cystic pancreatic lesions.

20 percutaneous aspirations, guided by ultrasound, were performed without serious complications in 17 patients with cystic pancreatic lesions. Amylase activities of all 10 pseudocysts were increased with a considerably wide range (3,680-775,000 U/l) and the serum amylase level correlated significantly (p less than 0.01) with the enzyme activity of cyst content. The enzyme level of 1 true cyst and 2 cystic malignancies were in the normal range of serum amylase; low amylase activity does not rule out a pancreatic origin of a cystic mass lesion. Bacteriological and cytological studies of aspirated samples revealed 2 (of 2) pancreatic abscesses and 2 ( of 3) cystic malignancies. Total regression of an acute pancreatic pseudocyst was achieved following repeated percutaneous antegrade evacuations.