The place of fine needle aspiration cytology for the intraoperative diagnosis of pancreatic malignancy.

We report a 91% accuracy with fine needle aspiration cytology in 46 patients found to have a mass in the pancreas at laparotomy. Results were compared with conventional biopsy at operation which was accurate in only 56% of an earlier group of 48 patients with a localised mass compared with 97% in 33 patients with disseminated malignancy. Although we strongly advise a through attempt to establish a histological or cytological diagnosis before operation, there are many occasions when a surgeon is faced with an undiagnosed mass in the pancreas at laparotomy. Under these circumstances fine needle aspiration cytology of the pancreas should be advised in units with an experienced cytology service.