ISSN 2398-2950      

Biopsy: pancreas

ffelis

Introduction

  • Pancreatic biopsy can facilitate the diagnosis of disorders such as acute and chronic pancreatitis, exocrine pancreatic insufficiency (EPI) and pancreatic neoplasia. 
  • Pancreatitis can be difficult to diagnose accurately ante-mortem because no diagnostic test has 100% sensitivity and specificity, although histological examination of the pancreas has been suggested as the gold standard for diagnosis of pancreatitis in dogs. 
  • Pancreatic biopsy may be performed open, laparoscopically or laparoscopically-assisted. Pancreatic aspiration can be considered as a less invasive option.

Uses

  • Diagnosis of pancreatic pathology and abnormalities, both primary and secondary. These may include (but are not limited to) pancreatitis Pancreatitis (acute and chronic), pancreatic neoplasia Pancreas: neoplasia, pancreatic insufficiency Exocrine pancreatic insufficiency, pancreatic cysts and benign nodular hyperplasia.

Advantages

  • Biopsy can provide a tissue for histology allowing pathological changes and organ architecture to be assessed.
  • Surgical biopsy allows visual assessment and palpation of the entire organ, which allows biopsies to be collected from the most appropriate location.
  • More than one sample can be collected if clinically indicated, eg absence of gross pathology.
  • If there are abnormalities in other abdominal organs these can be sampled at the same time.

Disadvantages

  • Tissue biopsy is invasive, requiring general anesthesia and surgery.
  • Excessive or rough handling during the biopsy procedure may lead to post-operative pancreatitis.
  • The reliability of a histologic diagnosis based on a single pancreatic biopsy sample is unclear.
  • It tends to provide a 'rule in' diagnosis rather than a 'rule out diagnosis'.

Requirements

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Preparation

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Procedure

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Aftercare

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Pratschke K M, Ryan J, McAlinden A et al (2015) Pancreatic surgical biopsy in 24 dogs and 19 cats: postoperative complications and clinical relevance of histological findings. Journal of Small Animal Practice 56 (1), 60-66 PubMed.
  • van den Bossche I, Paepe D, Saunders J et al (2010) Acute pancreatitis in dogs and cats: medical imaging, biopsy, treatment and prognosis. Vlaams Diergeneeskundig Tijdschrift 79 (2), 99-108 VetMedResource.
  • Webb C B & Trott C (2008) Laparoscopic Diagnosis of Pancreatic Disease in Dogs and Cats. Journal of Veterinary Internal Medicine 22 (6), 1263-1266 PubMed.
  • Watson P J, Roulois A J, Scase T et al (2007) Prevalence and breed distribution of chronic pancreatitis at post-mortem examination in first opinion dogs. Journal of Small Animal Practice 48 (11), 609-618 PubMed.

Other sources of information

  • Cornell K (2012) Pancreas. In: Veterinary Surgery Small Animal. Vol 2. 1st edn. Ed Tobias K, Johnston SA. Elsevier Saunders, St Louis, Missouri. pp 1659-1673.

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