[Diagnostic capability and clinical usefulness of percutaneous histological biopsy of the pancreas under control on ultrasound image using 21 gauge needle].

We evaluated diagnostic capability and clinical usefulness of histological diagnosis of the pancreas by percutaneous biopsy controlled on ultrasound image. Thirty seven patients with pancreas carcinoma and 11 with chronic pancreatitis underwent the procedure using 21 guage-Sonopsy C1 needle (Hakko co. Ltd.). Specimens of the tissue obtained were adequate for histological interpretation in 95.8% of all the 48 patients. The histological judgement referring to the nature of the lesion corresponded in 91.3% with the final diagnosis established surgical exploration, autopsy or long follow up more than one year. In cases of pancreas carcinoma with a successful procedure of the biopsy, histological type of carcinoma was confirmed in 91.4% of the tumors. It proved accordant pathologically with the conclusion based on the resected tumors in 5 of 8 patients operated on after the biopsy. Chronic pancreatitis was histologically diagnosed in 9 of the 11 patients with the biopsy. A confident diagnosis could not be obtained by imaging modalities including ultrasound, X-ray CT, ERCP and angiography in 7 of 37 patients with pancreas carcinoma and 3 of 11 with chronic pancreatitis. Biopsy by this method was so useful as to obtain the correct diagnosis in all these cases but one. Abdominal pain happened most frequently as a adverse effect during the procedure, but disappeared soon after that. There were no serious complications requiring intensive care. In conclusion, percutaneous histological biopsy controlled on ultrasound image may be recommended as a reliable method for making a definite diagnosis providing more valuable information than cytological biopsy, when diagnostic imaging modalities are unsuccessful in elucidating pathology of the pancreas.