Jamieson C, Bury K D, Colapinto N D
Can J Surg. 1977 Nov;20(6):546-50.
The authors carried out a retrospective review of intraoperative biopsy of the head of pancreas in 47 patients. Vim-Silverman needle biopsy (32 patients), or wedge biopsy (9 patients), or both (5 patients) were used. The correct diagnosis in the 34 patients with carcinoma was made in 76% by paraffin section and in 65% by frozen section. Diagnositic accuracy was 77% with needle biopsy and 38% with wedge biopsy. Complications occurred in six patients and consisted of pancreatitis, fistula and hemorrhage. Two patients required reoperation because of hemorrhage. The case of one patient who died of a pancreaticoperitoneal leak at the biopsy site is described in detail. The overall complication rate was 15%. These results indicate that wedge biopsy carries significant risks and frequently does not detect carcinoma. Needle biopsy is relatively safe and is more likely to provide an accurate diagnosis of carcinoma.
作者对47例胰腺头部术中活检进行了回顾性研究。采用Vim-Silverman针吸活检（32例）、楔形活检（9例）或两者联合使用（5例）。34例癌症患者中，石蜡切片诊断正确率为76%，冰冻切片诊断正确率为65%。针吸活检诊断准确率为77%，楔形活检诊断准确率为38%。6例患者出现并发症，包括胰腺炎、瘘管和出血。2例患者因出血需要再次手术。详细描述了1例患者在活检部位因胰周渗漏死亡的病例。总体并发症发生率为15%。这些结果表明，楔形活检风险较大，且常常无法检测出癌症。针吸活检相对安全，更有可能对癌症做出准确诊断。
