title: Laparoscopy and peritoneal cytology in the staging of pancreatic cancer.
abstract: Staging laparoscopy in patients with pancreatic cancer allows identification of metastatic disease which is beyond the resolution of computed tomography. Laparoscopic ultrasound, dissection, and/or peritoneal cytology may be used to enhance the sensitivity of the staging procedure. Our experience at Massachusetts General Hospital with staging laparoscopy and peritoneal cytology over the past 8 years (N = 239) reveals that approximately 30% of patients without metastases by computed tomography harbor occult metastatic disease at laparoscopy. Additionally, published series demonstrate accurate determination of resectability in greater than 75% of patients after staging laparoscopy. Staging laparoscopy in patients with pancreatic cancer allows optimization of resources and avoidance of unnecessary surgery.
authors.affiliation: Department of Surgery, Massachusetts General Hospital, 15 Parkman Street, WACC 336, Boston, Massachusetts, USA 02114, USA.
authors.forename: R E
authors.initials: RE
authors.lastname: Jimenez
authors.forename: A L
authors.initials: AL
authors.lastname: Warshaw
authors.forename: C
authors.initials: C
authors.lastname: Fernandez-Del Castillo
mesh_terms: D000328:Adult; D000368:Aged; D001202:Ascitic Fluid / Q000473:pathology*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008113:Liver Neoplasms / Q000473:pathology / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000601:surgery; D010533:Peritoneal Lavage; D010534:Peritoneal Neoplasms / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D012680:Sensitivity and Specificity