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Updated: Jun 21, 2026
Isolation of Proximal Fluids to Investigate the Tumor Microenvironment of Pancreatic Adenocarcinoma
Published on: November 5, 2020
The performance of intraoperative peritoneal washings in detecting pancreatic ductal adenocarcinoma
Sagar D Patel1, William R Burns1, Christopher J VandenBussche2
1Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
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.
