Diagnostic accuracy of laparoscopy in staging of pancreatic cancer patients

Introduction Pancreatic cancer is a devastating malignancy with nearly as many deaths as newly diagnosed cases each year. The 5-year survival rate is reported in the range between only 15 and 25% in most series. Accurate staging of patients with pancreatic cancer is crucial to clarify whether meaningful resection is indeed possible. Staging laparoscopy (SL) has been suggested as a tool for staging, which may spare up to two-fifth of these patients from undergoing nontherapeutic laparotomy. This study aimed at assessment of the role of laparoscopy in preoperative staging of patients with pancreatic cancer. Patients and methods This study was a prospective cross-sectional study, in which 26 patients with pancreatic cancers from May 2014 till May 2017 were included at Suez Canal University Hospital. Patients were subjected to undergo abdominal ultrasonography and abdominal computed tomography scan with pancreatic protocol. Patients had undergone SL with standard technique. Results Our study found that one patient in the resectable group was metastatic (1/16), whereas three patients in the borderline group were metastatic (3/10), with overall four patients (4/26) having metastasis on SL. Pattern of metastasis was liver metastases in 4% and peritoneal metastases in 11%. Male patients, older than 63 years, diabetic, cancer antigen (CA) 19-9 level more than or equal to 352 U/ml, tumors located at head, larger than 3 cm, and borderline resectable by computed tomography all may predict laparoscopically detectable metastases (P<0.05). Conclusion SL is necessary for patients with suspicious occult distant organ metastasis; but it is not a substitute of high-quality imaging.