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Role of Staging Laparoscopy in Patients Undergoing Pancreatoduodenectomy

Awais A Malik, Muhammad I Ashraf, Raza Hasnain, Aamir A Syed, Faisal Hanif. Shaukat Khanum Memorial Cancer Hospital & Research Center

Introduction: We aim to evaluate the role of staging laparoscopy in patients undergoing pancreatoduonectomy for pancreatic/periampullary tumors at our institution.

Methods: All patients planned for pancreatoduodenectomy who underwent staging laparoscopy between September 2014 and June 2016 were included. Findings at laparoscopy and whether a change in management plan occurred was recorded.

Results: Between September 2014 and June 2016, a total of 56 patients underwent staging laparoscopy before pancreatoduodenectomy. Of these, 9 patients were found to have liver lesions and 5 patients had peritoneal nodules. Among patients with liver lesions, 2 patients had metastatic pancreatic adenocarcinoma, one had metastatic neuroendocrine tumour, while the other three had benign lesions on histopathology. All the patients with peritoneal nodules turned out to have benign lesions on histopathology of these nodules. Management plan was changed in three patients due to staging laparoscopy. Two patients were planned for curative resection but liver lesions consistent with metastatic pancreatic carcinoma were found making them irresectable. The other patient was previously known to have a liver lesion the biopsy of which showed a neuroendocrine tumour thus making him potentially resectable.

Conclusion: Staging laparoscopy is a useful investigation for patients planned for pancreatoduodenectomy with curative intent as it helps to detect small volume peritoneal and liver metastatic disease. If any liver or peritoneal lesions are encountered, biopsy is useful in differentiating benign lesions from metastatic disease.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 80067

Program Number: P102

Presentation Session: Poster (Non CME)

Presentation Type: Poster

76

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