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Answer 4
  1. CT scan and laparoscopy. It is generally accepted that computed tomographic (CT) scans have an excellent predictive capacity to identify unresectable pancreatic cancer; however, resectability may not be determined in up to 20% of patients. CT scans fail to detect metastatic tumors that are smaller than 5 mm in diameter, such as small-volume peritoneal and hepatic metastases. Accurate staging is the cornerstone of treatment decisions for patients with pancreatic cancer; thus, diagnostic laparoscopy is indicated because it enables visual examination of the liver and the peritoneum and provides the capacity to biopsy potential extrapancreatic disease.

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