Intraoperative pancreatic fine needle aspiration biopsy. Results in 166 patients.
 Intraoperative fine needle aspiration biopsy (NAB) of undiagnosed pancreatic masses was studied in 166 patients over a 17-year period.
 The cytologic diagnoses were correlated with histologic specimens, autopsy results, or clinical follow-up (benign disease was documented if the patient was alive without malignancy at least 2 years after laparotomy).
 Aspirates were interpreted as benign, suspicious, malignant, or unsatisfactory.
 Malignant disease was the final diagnosis in 109 patients; the cytology was concordant in 101 and was interpreted as suspicious in four.
 Four patients with benign cytology later proved to have malignant disease--a false-negative rate of 2.5 per cent.
 A total of 57 patients had benign disease; 51 of these had benign cytology.
 The remaining patients had "unsatisfactory" cytology reports.
 A 93 per cent sensitivity, 100 per cent specificity, and 0 per cent complication rate are reported.
 There were no false-positive cytology reports.
 Complications are rare and represent case reports, thus, additional sampling is at minimal risk.
 Intraoperative pancreatic NAB is a safe, easy, more accurate biopsy technique than historical wedge or core needle biopsies.
 It is the biopsy method of choice for pancreatic masses found at laparotomy.
