Laparoscopic Staging in Patients with Newly Diagnosed Pancreatic Cancer View Full Text


Ontology type: schema:Chapter     


Chapter Info

DATE

2018-04-12

AUTHORS

Timothy Gilbert , Ryan Baron , Paula Ghaneh , Christopher Halloran

ABSTRACT

Prompt accurate staging See Staging laparoscopy (SL)is paramount in managing patients with newly diagnosed pancreatic cancer. Initially, diagnosis and staging are undertaken using contrast-enhanced 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) CA 19–9>150 kU/L (>300 when 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 PET-CT may lead to improvements in the detection of small previously radiologically occult metastases and may reduce the future role of SL/L-LUS. More... »

PAGES

753-769

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/978-1-4939-7193-0_80

DOI

http://dx.doi.org/10.1007/978-1-4939-7193-0_80

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1103221537


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