The following parameters were retrospectively evaluated in 64 patients with suspected pancreatic neoplasm: (1) time required to obtain cytohistologic diagnosis, (2) days in hospital, (3) number and type of surgical operations, and (4) total hospital costs. Echo-guided fine needle biopsy (FNB) was performed on 34 patients (FNB group) and in a further 30 patients diagnostic workup did not include percutaneous biopsy (laparotomy group). Both diagnostic and hospital stay were shorter (8 and 7 days, respectively) in the FNB group than in the laparotomy group. In the FNB group, surgery was avoided in 18 patients, while in the laparotomy group 18 explorations proved diagnostic alone. Finally, FNB was shown to reduce hospital costs by 23%.