Cytologic examinations of both bile and duodenal juice were performed on patients with lesion in billiary tract and pancreas. The bile was drained from intrahepatic duct when the percutaneous transhepatic choleangiography was done, and the duodenal juice was obtained on the occasion of the hypotonic duodenography. The drained specimen was poured immediately into a centrifuge tube containing chilled physiological saline water to prevent degeneration of the cells, and centrifuged at1500 rpm for 5 minutes. The sediment was stirred in a cell modified by Shibata with the saline waterand centrifuged again with an Autosmear (Sakura Finetechnical Co. Ltd.). Detection of cancer cells in the bile was more satisfactory by the present method than by direct smearing of the bile.
Reliability of cytologic diagnosis of the bile and the duodenal juice was assertained also by pathological diagnosis by autopsy or surgical operation on thirty three patients, and 16 cases were found to be malignant and 17 cases benign. By cytologic diagnosis of the bile on 16 malignant cases, 11 cases were positive, 4 negative, and 1 suspicious. For 9 cases of 16 malignant cases, cytologic diagnosis of the duodenal juice were taken, and 6 cases were positive and 3 negative. As all the 17 benign cases were negative in cytologic diagnosis, there was no false positive. Of 9 cases examined cytologically in both the bile and the duodenal juice, 8 cases were positive for either or both. In conclusion, 13 of 16 malignant cases were positive in cytologic diagnosis on the bile or the duodenal juice.
