LAPAROSCOPIC BIOPSY OF THE PANCREAS

Abstract

The purpose of this study was to observe the pancreas by laparoscope and to perform biopsy. I have employed an ordinaly type of laparoscope and tried to observe the pancreas covered with thin lesser omentum (a patient, 15° head elevation position). Through this method, the pancreas was observed in 66% out of 1, 000 patients. As to biopsy, forceps biopsy (Robber's forceps or forceps for gastric biopsy) was conducted in a soft pancreas (mild acute pancreatitis, mild chronic pancreatitis, diabetes mellitus etc.), while needle biopsy (Vim-Silverman needle, Tru-Cut needle and Menghini needle) was conducted in a hard pancreas (severe acute pancreatitis, severe chronic pancreatitis, pancreas cancer etc.). When I reviewed the results of various tools employed, a seccess rate of forceps biopsy was 71% and that of needle biopsy was 84% (Vim-Silverman needle, 100%, Tru-Cut needle, 100%, Menghini needle, 72%.). A tissue obtained by Robber's forceps or needle biopsy always contained several islets. The percentage of tissue's inclusion of an islet or more islets was 60% when obtained by forceps for gastric biopsy. I experienced 3 accidental cases (1.05%) out of 285 biopsy cases, two cases of hemorrhage and one cases of leakage of pancreasjuice. Two patients have completely recovered by surgical operation and one patient have recovered conservatively. There was no mortality.