Laparoscopic Staging in Patients with Newly Diagnosed Pancreatic Cancer

  • Timothy Gilbert
  • Ryan Baron
  • Paula Ghaneh
  • Christopher Halloran
Reference work entry


Prompt accurate staging 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.


Pancreas Pancreatic cancer Laparoscopy Laparoscopic ultrasound Diagnosis Staging 


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Timothy Gilbert
    • 1
  • Ryan Baron
    • 1
  • Paula Ghaneh
    • 2
    • 1
  • Christopher Halloran
    • 1
  1. 1.Department of Molecular and Clinical Cancer MedicineInstitute of Translational Medicine, University of LiverpoolLiverpoolUK
  2. 2.Department of SurgeryThe Royal Liverpool and Broadgreen University Hospitals NHS TrustLiverpoolUK

Section editors and affiliations

  • James L. Abbruzzese
    • 1
  • Raul A. Urrutia
    • 2
  • John Neoptolemos
    • 3
  • Markus W. Büchler
    • 4
  1. 1.Duke University Medical CenterDurhamUSA
  2. 2.Mayo Clinic Cancer CenterMayo ClinicRochesterUSA
  3. 3.Division of Surgery and OncologyUniversity of LiverpoolLiverpoolUK
  4. 4.Department of General, Visceral and Transplantation SurgeryUniversity of HeidelbergHeidelbergGermany

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