[Percutaneous, ultrasound-targeted fine-needle puncture biopsy (liver, pancreas, intestine) and ultrasound-targeted pancreatic duct puncture].

Ultrasonically guided fine-needle aspirations were done in the liver of 42 cases of malignancy established later by autopsy and biopsy. The sensitivity was 95.3%. Only in one case, in a metastasis of renal carcinoma, precise tumour classification was not possible cytologically. Pancreatic malignancies were biopsied in 28 cases with later verified diagnoses at post mortem and biopsy; the sensitivity was 85.7%. One pancreatic head adenocarcinoma tumour classification was not possible cytologically. In 16 cases of gastrointestinal carcinoma verified by operation the sensitivity was 93.8%. In one cirrhotic gastric carcinoma only insufficient cytological material could be aspirated despite several biopsies. There were no false positive results in any puncture. The cytological results in all malignancies (n = 86) agreed in 97.7% with later established histological tumour classifications. Two clinically relevant complications were observed (biliary peritonitis, haemoperitoneum). In 15 percutaneous fine-needle pancreaticographies it has been shown to be an advantage that pancreatic juice can be aspirated prior to contrast medium filling of the pancreatic duct. Hyperinstillation into the organ can thus be prevented. In addition, the pancreatic juice aspirate can be investigated cytochemically. Only part of the patients (indurating changes of the pancreas such as chronic pancreatitis) experienced an unpleasant or painful sensation. For this reason such patients should be given analgesics.