Journal of Ultrasound in Medicine, Vol 15, Issue 3 207-212, Copyright © 1996 by American Institute of Ultrasound in Medicine
Comparison of laparoscopic and transabdominal ultrasonography in staging of cancer of the pancreatic head region
O. M. van Delden, N. J. Smits, W. A. Bemelman, L. T. de Wit, D. J. Gouma and J. W. Reeders
Department of Diagnostic Radiology, Academic Medical Centre, University of Amsterdam, The Netherlands.
The value of laparoscopic ultrasonography in the staging of cancer of the
pancreatic head region was compared prospectively to that of transabdominal
ultrasonography. Eighty patients underwent LUS, after ultrasonography had
shown normal Doppler findings of portal vessels and no signs of metastatic
disease. Presence of hepatic or lymph node metastases and vascular tumor
infiltration were evaluated in 74 and 48 patients, respectively.
Laparoscopic ultrasonography showed liver metastases in 10 patients (14%).
Specificity and positive predictive value for the laparoscopic technique
determining vascular ingrowth were 97% and 92%, respectively, versus 89%
and 77% by sonography in patients with normal Doppler findings (difference
not statistically significant). Laparoscopic ultrasonography has shown
improved detection of hepatic metastases compared to sonography, but it
still must prove its value, as compared to noninvasive methods, in local
staging.
