Laparoscopic peritoneal cytology in the staging of pancreatic and periampullary cancer

John, Timothy G.; McGoogan, E; Wigmore, Stephen J.; Paterson-Brown, Simon; Carter, D.C.; Garden, O. James

doi:10.1016/s1365-182x(17)30601-9

Cited by 3 publications

(5 citation statements)

References 19 publications

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“…Detecting scanty malignant cells amongst reactive and degenerative mesothelial cells can be difficult. It has been suggested that immunocytology may improve the detection of malignant cells [3].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, no patients had prior FNA or biopsy. In the study of John and associates [3], they found positive peritoneal cytology on conventional staining in seven of 46 patients, three of whom had had prior percutaneous needle aspiration or biopsy. Laparoscopic ultrasound was used as part of our staging assessment, and it demonstrated lymph node and hepatic metastases (with histological confirmation) that were not detected by the other staging modalities.…”

Section: Discussionmentioning

confidence: 99%

“…Washing the peritoneal cavity at the time of operation and examining the fluid cytologically has been performed in a variety of malignancies [1,2] including colorectal, stomach, biliary and pancreatic cancers. Positive peritoneal cytology in pancreatic and periampullary cancer is associated with a grave prognosis, with a median cumulative survival at 3 and 6 months of 17% and 8% compared with 87% and 71% in patients with negative peritoneal cytology [3]. In pancreatic carcinoma, most peritoneal cytology studies have been performed by lavage at laparotomy, although it would obviously be desirable to obtain this staging information laparo‐scopically.…”

Section: Introductionmentioning

confidence: 99%

“…In pancreatic carcinoma, most peritoneal cytology studies have been performed by lavage at laparotomy, although it would obviously be desirable to obtain this staging information laparo‐scopically. A few studies examining laparoscopic peritoneal lavage have been performed with conventional cytological examination of the specimen [3].…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic peritoneal lavage cytology and immunocytology in pancreatic and periampullary carcinoma

Midwinter

Watson

Wadehra

et al. 2001

HPB

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Laparoscopic peritoneal lavage cytology and immunocytology in pancreatic and periampullary carcinoma

Midwinter

Watson

Wadehra

et al. 2001

HPB

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“…Installation into the peritoneal cavity of up to 500 ml normal saline solution at room temperature was used to optimize transducer contact and minimize down-pressure. This instilled fluid also served as peritoneal washings for peritoneal cytologic analysis, which is the subject of a separate report [13].…”

Section: Laparoscopy With Laparoscopic Ultrasonographymentioning

confidence: 99%

Laparoscopy with Laparoscopic Ultrasonography in the TNM Staging of Pancreatic Carcinoma

Wright

et al. 1999

World j. surg.

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A prospective study was performed comparing laparoscopy with laparoscopic ultrasonography (LapUS), transabdominal ultrasonography (USS), computed tomography (CT), and selective visceral angiography with portal phase venography (SVA) for the assessment of resectability in 50 patients with pancreatic or periampullary cancer. The results were stratified by TNM stages. Tumor unresectability was demonstrated in 36 patients (72%). The sensitivity of LapUS for demonstrating the index lesion was 96%. Laparoscopic ultrasonography failed to predict factors precluding resection by T stage in six patients, and there were no significant differences in the ability of any modality to predict local resectability (predictive value 58-73%). Laparoscopic ultrasonography did not overestimate T stage and was significantly more specific for assessing unresectability compared with USS (100% vs. 64%, p<0.05) and CT (100% vs. 47%, p<0.005). No imaging investigation was able to assess the N stage accurately. Metastases were confirmed in 16 patients (32%), with LapUS proving significantly more sensitive than USS (94% vs. 29%, p<0.001) and CT (94% vs. 33%, p<0.005). The addition of LapUS to the laparoscopic examination did not change the M stage in any patient, as all metastases were superficially located. Laparoscopy with LapUS was the most reliable method for assessing overall tumour resectability and was significantly more predictive than CT (97% vs. 79%, p<0.005). These results confirm that laparoscopy is indispensable for detecting occult intraabdominal metastases. LapUS reliably predicts tumor unresectability, offsetting the tendency of USS and CT to overestimate T stage. Methods of accurate N staging remain elusive, and the use of routine SVA is not justified.

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The injured bile duct: converting the unconverters

Williamson¹

2000

HPB

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Laparoscopic peritoneal cytology in the staging of pancreatic and periampullary cancer

Cited by 3 publications

References 19 publications

Laparoscopic peritoneal lavage cytology and immunocytology in pancreatic and periampullary carcinoma

Laparoscopic peritoneal lavage cytology and immunocytology in pancreatic and periampullary carcinoma

Laparoscopy with Laparoscopic Ultrasonography in the TNM Staging of Pancreatic Carcinoma

The injured bile duct: converting the unconverters

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