Pancreatic cancer. Laparoscopic staging and peritoneal cytology.

Laparoscopy is an indispensable study if precise preoperative staging for pancreatic cancer is required. It will identify liver, peritoneal, or omental implants in 22% to 48% of patients who have no other evidence of disseminated disease by CT. Performing peritoneal washings at the time of laparoscopy will disclose an additional 8% of patients with micro metastases and who have an equally poor prognosis as those with visible metastases.