Abstract

Pancreatic cancer is one of the leading causes of death among gastrointestinal malignancies. Chronic pancreatitis (CP) is strongly associated with pancreatic malignancy and may be the causative factor. Most of the pancreatic tumours (70 %) and most of inflammatory masses in CP are situated in the head of pancreas. Common pancreatic malignancies include adenocarcinomas (90%), cystic neoplasms (5%), and neuroendocrine tumors (2-5%). Preoperative tissue diagnosis is necessary in certain situations. The common techniques used to image pancreas are computerised tomography (CT), abdominal ultrasound, endoscopic ultrasonography (EUS) and ERCP. For those patients who have an imaging characteristic of benign disease, either conservative or drainage procedures can be performed. For patients who have an imaging characteristic of malignant head mass, pancreatico-duodenectomy or palliative procedure can be performed depending on the stage of the disease. There exists an indeterminate group of patients who cannot be categorised as benign or malignant based on imaging. It is for this group of patients where tissue diagnosis plays an important role for proper treatment selection for the patient. Ultrasound (USG) guided fine needle aspiration cytology (FNAC) is a highly useful tool in this subset of patients with indeterminate mass. In this study we have evaluated various etiological factors. diagnostic modalities and effective usefulness of ultrasound guided FNAC in diagnosis of malignancy in chronic pancreatitis with head mass and its management.

Keywords: Tumor markers, USG guided FNAC, pancreatectomy.