Slovenská chirurgia 4/2015
Intraoperative biopsy of the pancreas with chronic pancreatitis unclear
Introduction: Chronic pancreatitis is a risk factor for pancreatic cancer. Exact preoperative diagnosis is not always possible despite the modern morphological imaging methods. Our study reports on the possibilities of intraoperative biopsy and its yield compared with final histology and subsequently selected surgical strategy. We describe a retrospective analysis of 120 patients to surgical s proces due to chronic pancreatitis and its complications in the years 2005 – 2012. Methods: The patients were assigned on the basis of a possible etiology and by morphological imaging methods in two groups: resolved diagnosis and problematic differential diagnosis of chronic pancreatitis. Results: The intraoperative biopsy was indicated in 26 %, 7 of patients. In 9 cases it was not possible to establish dignity of disease by peroperative biopsy and in one case it was false negative result. Preferred type of surgery in the group with problematic differential diagnosis was resection − 60 %. Conclusion: In patients with chronic pancreatitis suspicious for malignancy is fully indicated resection unless local findings and general condition of the patient allows. For polymorbid patients with borderline findings in terms of local resection may be beneficial intra- operative biopsy.
Keywords: chronic pancreatitis, differential diagnosis, intraoperative biopsy
