Operative pancreatic biopsy. Ten year review of accuracy and complications

Accurate diagnosis is necessary for the rational treatment of malignant disease. For patients with pancreatic cancer, the requirement for histologic confirmation of diagnosis is sometimes waived, relying instead on gross operative findings. With the introduction of even more radical surgery and radiotherapy for the treatment of pancreatic cancer, the importance of accurate diagnosis becomes even greater. In order to determine the reliability and safety of operative pancreatic biopsy, we have reviewed the past ten years' experience (52 patients) at Thomas Jefferson University Hospital. Malignant neoplasm was strongly suspected in 16 patients based on gross findings, but cancer could not be confirmed microscopically. Follow-up studies showed that eight of these 16 patients, in fact, did have malignancies. Accuracy was otherwise excellent. The overall results from this large series suggest that biopsy can be safely and reliably performed.