Intraoperative Endoscopic Ultrasound for Pancreatic Cancer

Nowadays pancreatic cancer is one of the deadliest oncological pathologies today. Even after curative surgery, considered the only effective curative tool, 5-years survival does not exceed 5%. Before surgery, an endoscopic ultrasound is performed on the patient to carry out the biopsy of the main tumor. However, the evaluation being devoted to the pancreas, this study wishes to extend echoendoscopie to lymph node staging away from the surgical field. The proposed study is based on the hypothesis that the implementation of a simple classification of lymph nodes, based on non-invasive ultrasound criteria, would facilitate the location and qualification of peripancreatic lymph nodes and distant from the tumor, and therefore the staging of the tumor.

At the same time, the video data obtained will be collected in a computer database in order to create an artificial intelligence lesion detection and qualification tool.

This study plans to recruit 45 adult patients, male or female, with a solid or cystic pancreatic tumor and for whom a surgical resection (first line and after neoadjuvant treatment) is planned. The main objective is to estimate the sensitivity and specificity of a simple classification "benign / malignant" of the nodes, established by the endoscopist using endoscopic ultrasound criteria's, compared to the gold standard (anatomopathology).

Inclusion criteria

• Patient over 18 years old
• Patient with a solid or degenerated cystic tumor of the pancreas requiring curative surgery
• Patient with a complete clinical examination performed
• Patient with no contraindication to anesthesia, upper digestive endoscopy and pancreatic surgery
• Patient able to receive and understand information relating to the study and give informed written consent
• Patient affiliated to the French social security system

Exclusion criteria

• Patient presenting with bleeding disease with disorder hemostasis and coagulation (PT <60%, TCA> 40 s and platelets <60,000 / mm3)
• Patient on anticoagulant or antiaggregant treatment that cannot be temporarily interrupted
• Patient carrying a right-left shunt, a severe pulmonary arterial hypertension (high blood pressure pulmonary> 90 mm Hg), uncontrolled systemic hypertension or suffering from respiratory distress syndrome.
• Pregnant or breastfeeding patient
• Patient in exclusion period (determined by a previous study or in progress)
• Patient under legal protection
• Patient under guardianship or trusteeship