[Intraoperative pancreas puncture cytology]

Area of Science:

• Gastroenterology
• Surgical Pathology
• Cytopathology

Context:

• 10-15% of surgical patients with pancreatic disorders require intraoperative diagnosis.
• Preoperative diagnoses are often inconclusive for pancreatic conditions.
• Accurate intraoperative assessment is crucial for guiding surgical decisions.

Purpose:

• To evaluate the efficacy and safety of intraoperative fine needle aspiration biopsy (FNAB) of the pancreas.
• To determine the diagnostic accuracy of FNAB in differentiating malignant and benign pancreatic processes.
• To compare FNAB with traditional histological methods for pancreatic lesion diagnosis.

Summary:

• 244 pancreatic FNABs were performed on 100 patients, achieving a diagnostic statement in 99% of cases.
• Cytological diagnosis was correct in 83% of cases, with a 7% false-negative rate and no false-positive cancer diagnoses.
• FNAB demonstrated a low risk factor, with no major postoperative complications and transient hyperamylasemia in 25% of patients.

Impact:

• FNAB is recommended over histological tissue removal due to its lower risk profile.
• This technique provides a reliable basis for intraoperative differentiation of pancreatic pathologies.
• Effective for diagnosing challenging pancreatic cases, improving patient management and surgical outcomes.