The performance of intraoperative peritoneal washings in detecting pancreatic ductal adenocarcinoma.

BACKGROUND

Accurate peritoneal staging is critical in pancreatic ductal adenocarcinoma (PDAC), as the presence of peritoneal metastases significantly alters prognosis and treatment strategy. In this setting, some centers use peritoneal washings (PWs), which allow the sampling of a large area of the peritoneal surface in the absence of a visible lesion, to improve peritoneal staging and improve selection for curative-intent surgery.

METHODS

The authors conducted a retrospective review of 28 patients who underwent cytopathologic evaluation of intraoperative PWs collected between July 2019 to July 2024.

RESULTS

There was high concordance between PWs and concomitant biopsy. Six patients had positive PWs. Of these six patients, five of them had concordant findings noted on biopsy. There was one patient who had benign findings on biopsy despite having a malignant PW. In a similar fashion, 22 patients had PWs that were negative. Nineteen of these patients had concordant findings noted on biopsy. The remaining three patients had biopsy-confirmed metastasis despite benign findings noted on PW.

CONCLUSION

Peritoneal washings can enhance the detection of peritoneal involvement by PDAC while minimizing false-positive diagnoses.