[Ultrasonically guided biopsy of mass lesions in the pancreas, liver and gallbladder].

The first paper describing ultrasonically guided biopsy of the kidney was reported by Berlyne in 1961. The next important development was the production by Holm and Goldberg in 1972 of a special pilot transducer with a central cannula through which a fine needle could be introduced. The present author reported the definitive diagnosis of pancreatic carcinoma with percutaneous aspiration biopsy using contact compound scanning methods in 1977. A new para real time method has been recently the developed to allow needle puncture we through the pancreas, liver and gallbladder. The needles and commonly used have been 22 and 23-gauge and 15 or 20 cm in length. Cytological diagnosis of adenocarcinoma of the pancreas was made with an accuracy of 40 cases out of 45 (89%). That for the liver and gallbladder was 100%. On inserting the needle into the gallbladder for cytological examination, a biochemical analysis of bile juice , CEA and LDH, was performed, as for cases of pancreatic cyst. In gallbladder carcinoma, LDH and CEA showed significantly higher levels than in benign mass lesions. The merits of ultrasonic real time guidance for puncture technique are safety, ability of hitting a small target accurately, short time requirement, harmlessness and ease of use at the bedside.