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- W4385568907 abstract "More than 80% of patients with pancreatic cancer are diagnosed as having unresectable diseases due to local invasion and/or distant metastases involving the liver and peritoneum. Moreover, in about 40% of patients with potentially resectable pancreatic cancer on preoperative evaluation by computed tomography, unresectable disease is detected intraoperatively and they end up with unnecessary “open-and-close laparotomy.” Such a condition is called “occult metastases.” Staging laparoscopy (SL) is a minimally invasive technique used to detect occult metastases. SL is typically composed of exploration of the peritoneal cavity including the Douglas pouch, lesser sac, and liver surface, as well as lavage cytology and sampling of possible metastatic tissues for histologic evaluation. Intraoperative ultrasound is also useful in evaluating liver metastases and local invasion. Detection of occult metastases during SL can preclude “open-and-close laparotomy” and facilitate appropriate treatments based on accurate staging. The National Comprehensive Cancer Network Guidelines Version 2.2021 recommend considering SL in high-risk patients for potential metastases, including those with borderline resectable disease, markedly elevated CA 19-9, large primary tumors, and/or large regional lymph nodes. In this chapter, we describe the indications and procedure of SL and the significance of peritoneal cytology for pancreatic cancer with special reference to current topics in the era of highly sensitive imaging modalities, minimally invasive approach to pancreatic resections, and frequent use of neoadjuvant therapy." @default.
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- W4385568907 date "2023-08-04" @default.
- W4385568907 modified "2023-10-14" @default.
- W4385568907 title "The Role of Laparoscopy and Peritoneal Cytology in the Management of Pancreatic Cancer" @default.
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- W4385568907 doi "https://doi.org/10.1002/9781119876007.ch133" @default.
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