[Effectiveness of intraoperative cytological examination of peritoneal washings for patients with pancreatic cancer].

To confirm the effectiveness of cytological examination of peritoneal washings for detecting invisible micro-peritoneal dissemination in patients with pancreatic cancer, results were analyzed with the survival and the background factors of the patients. Cytological examination of peritoneal washings or ascitic fluid at recto-vesical pouch or pouch of Douglas was performed in 37 patients with primary pancreatic cancer. Positive results for cancer cells were obtained in five of 9 patients (55.6%) who received cytological examination of ascitic fluid and in seven of 28 patients (25.0%) who received that of peritoneal washings. Four of 6 patients (66.7%) with visible peritoneal dissemination showed positive results. These 6 patients died of peritoneal dissemination with about 10 months. Eight of 31 patients (25.8%) without visible peritoneal dissemination showed positive results of the cytological examination. Two of the 8 patients received resection of the tumor. Other 6 patients without resection developed clinically evident peritoneal carcinomatosis. A high positive rate (66.7%) of cytological examination of the patients with visible peritoneal dissemination and a high incidence of appearance of peritoneal carcinomatosis in patients with positive cytological results but without visible peritoneal dissemination (75.0%; positive vs 26.1%; negative) indicate a high reliability of the cytological examination to detect invisible micro-peritoneal dissemination.