Review Article | DOI: https://doi.org/-

Optimizing Surgical Exploration in Pancreatic Cancer Through Tailored Staging Laparoscopy After Neoadjuvant Treatment

  • Bridjet jones *

Independent Researcher, Department of Cardiology, Indiana, United States of America

*Corresponding Author: Bridjet jones

Citation: B jones, Optimizing Surgical Exploration in Pancreatic Cancer Through Tailored Staging Laparoscopy After Neoadjuvant Treatment, International Journal of Medical Sciences and Research, ACP Publishers, 1(1);
DOI: https://www.doi.org/acp/2026/ijmsr/00006

Copyright : © 2026 Bridjet jones, this is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited are credited

Received: 12 May 2026 | Accepted: 16 May 2026 | Published: 19 May 2026

Keywords: pancreatic ductal adenocarcinoma, pancreatic cancer, staging laparoscopy, neoadjuvant therapy, occult metastases, non-therapeutic laparotomy

Dr. Optimizing Surgical Exploration in Pancreatic Cancer Through Tailored Staging Laparoscopy After Neoadjuvant Treatment

Pancreatic ductal adenocarcinoma (PDAC) remains one of the deadliest gastrointestinal malignancies despite recent advances in multimodal treatment approaches. Neoadjuvant chemotherapy and chemoradiotherapy have improved patient selection for surgery and enhanced respectability rates in borderline respectable pancreatic cancer. However, occult metastatic disease remains a significant clinical challenge, frequently leading to non-therapeutic laparotomy during intended curative surgical exploration. This study evaluates the role of tailored staging laparoscopy [SL] in detecting hidden metastatic disease after neoadjuvant treatment and preventing unnecessary laparotomy in patients with respectable and borderline respectable PDAC. Patients were stratified based on tumour size and serum CA19-9 levels to identify individuals at increased risk of occult metastases. Selective SL demonstrated improved detection of peritoneal and hepatic metastases that were not identified on preoperative imaging. Patients with tumour size ≥3 cm and CA19-9 >500 U/mL exhibited significantly higher rates of occult metastatic disease. Tailored SL reduced the incidence of non-therapeutic laparotomy, minimized surgical morbidity, and facilitated earlier initiation of systemic therapy.

Keywords:
pancreatic ductal adenocarcinoma, pancreatic cancer, staging laparoscopy, neoadjuvant therapy, occult metastases, non-therapeutic laparotomy

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