What are the indications of staging laparoscopy in the management of pancreatic cancer?

Updated: Mar 07, 2019
  • Author: Tomislav Dragovich, MD, PhD; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
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Answer

Others, including the NCCN panel, advise more a selective approach to staging laparoscopy, recommending its use in patients with any of the following indications [59, 60, 61, 2] :

  • CA 19-9 level >150 U/mL
  • Low volume ascites
  • Tumors in the body of the pancreas
  • Borderline resectable tumors,
  • Tumor size >3 cm
  • Common bile duct lymphadenopathy

Another argument for selective versus routine staging laparoscopy is the fact that in many cases where the tumor is deemed unresectable, laparoscopy would not have shown the vascular invasion or retroperitoneal invasion that ultimately leads to unresectability of tumor.


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