Ultrasound-guided fine needle biopsy and laparoscopy in the study of pancreatic masses: report on 136 cases.

The authors report their experience from 136 fine needle ultrasound (FN-US)-guided biopsies and laparoscopies. The pancreatic diseases considered by these methods were as follows: 9 cases of Pancreatitis, 11 cases of Pancreatic cysts, 5 cases of endocrine cancer, 109 cases of Exocrine cancer and 2 not conclusive cases. Diagnostic accuracy of FNB and laparoscopy was evaluated for each group and, in particular, for cancer patients. In the latter group, FNB helped to detect abdominal diffusion in 25 cases (33%) while laparoscopy, including laparoscopic washing, revealed a micro-diffusion in 31 cases (55%), the latter not shown previously by CT, RNM and US. The combination of these methods allows us to confirm the advanced stage of the majority of pancreatic cancers at onset. Furthermore, this seems to be a very reliable method to select resectable patients, thus avoiding useless, sometimes hazardous and expensive further investigation.