OBJECTIVETo investigate the value of the intraoperative fine-needle aspiration cytology (IFNAC) in the diagnosis of pancreatic cancer.

METHODSThe IFNAC data of 70 pancreatic cancer patients were retrospectively reviewed. IFNAC had been done in our hospital only in a few patients before 2001, however, more and more patients have been examined by renovated method since 2002. But as the way of carrying out IFNAC improved by changing from the ordinary 10 ml syringe and 22 gauge needle (0.7 mm) before 2003 to 5 ml syringe and 25 gauge skin testing needle (0.5 mm), the panreas itself is properly exposed before IFNAC, the operator at frst fixes the suspected mass with his left hand and does the puncture with his right hand. Puncturing is done while the syringe is rotated, negative pressure is being kept at the same time. The needle is withdrawn under negative pressure, 6-8 syringe are used for each patient by puncturing at 6-8 points, then smears are made with the syringes. The whole process takes 20 min to accomplish.

RESULTSThe overall positive rate was 84.3%. The positive rate of the conventional IFNAC was 66.67%, while it was increased to 95.3% following the introduction of the renovated method (P = 0.002); No complication was observed in this series.

CONCLUSIONIntraoperative fine-needle aspiration cytology using 25 gauge skin testing needle and multi-point rotating maneuver during puncturing in the diagnosis of pancreatic cancer is safe and effective with few complications.