Laparoscopic Staging in Patients with Newly Diagnosed Pancreatic Cancer

Gilbert, Timothy ORCID: 0000-0003-4821-1897, Baron, Ryan, Ghaneh, Paula and Halloran, Christopher ORCID: 0000-0002-5471-4178 (2018) Laparoscopic Staging in Patients with Newly Diagnosed Pancreatic Cancer. In: Pancreatic Cancer. Springer New York, pp. 753-769. ISBN 9781493971916

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Abstract

Prompt accurate staging is paramount in managing patients with newly diagnosed pancreatic cancer. Initially, diagnosis and staging are undertaken using contrastenhanced multidetector computerized tomography (CE-MDCT) or magnetic resonance imaging (MRI), supplemented with endoscopic ultrasound in selected cases. Staging laparoscopy (SL) with or without laparoscopic ultrasound (L-LUS) has been found to detect occult disease in 13-28% of patients with pancreatic cancer who are considered potentially resectable on imaging; however, between 1% and 30% of patients thought to be resectable on SL/L-LUS have subsequently been found to have unresectable disease. The clinical utility of SL/L-LUS can be enhanced by adopting a selective approach, only undertaking SL/L-LUS when one or more criteria are present, including (1) presumed pancreatic primary >3 cm diameter, (2) lesions in the body and tail of the pancreas, (3)CA19-9>150 kU/L (>300when total bilirubin >35 micromol/L), and (4) platelet/lymphocyte ratio >150. The judicious use of SL/L-LUS and cross-sectional imaging are complementary; however, the advent of PETCT may lead to improvements in the detection of small previously radiologically occult metastases and may reduce the future role of SL/L-LUS.

Item Type:	Book Section
Uncontrolled Keywords:	Digestive Diseases, Cancer, Clinical Research, Pancreatic Cancer, Rare Diseases, Biomedical Imaging, 4.2 Evaluation of markers and technologies, 4.1 Discovery and preclinical testing of markers and technologies, 4 Detection, screening and diagnosis, Cancer
Depositing User:	Symplectic Admin
Date Deposited:	25 Aug 2016 13:27
Last Modified:	15 Mar 2024 02:32
DOI:	10.1007/978-1-4939-7193-0_80
Related URLs:	Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3003031