Usually an experienced surgeon can identify correctly the nature of a mass in the pancreas by inspection and palpation. The consistency of the lesion, presence or absence of involvement throughout the pancreas, evidence of inflammatory reaction, presence of calcification or fat necrosis, existence of lymphadenopathy in the vicinity, secondary effects of the pancreatic lesion on the biliary tract, and evidence of extension of the process to surrounding tissues aid in establishing an accurate diagnosis. In addition, the patient's age and history and the results of preoperative clinical investigation may provide important leads to the diagnosis prior to laparotomy. On the other hand, even the experienced surgeon may have difficulty at times in determining the exact nature of a lesion in the pancreas by gross findings alone. Appropriate surgical treatment of the lesion usually requires an exact diagnosis, as is true with other surgical lesions.
Errors in surgical diagnosis of pancreatic
COTÉ J, DOCKERTY MB, PRIESTLEY JT. An Evaluation of Pancreatic Biopsy with the Vim-Silverman Needle. AMA Arch Surg. 1959;79(4):588-596. doi:10.1001/archsurg.1959.04320100054009