• Safety, as determined by the number of adverse events [ Designated as safety issue: Yes ]
  
• Feasibility, in terms of the proportion of patients in whom a sentinel lymph node is identified [ Designated as safety issue: No ]
  
• Ability of surgically defined sentinel lymph nodes to predict whether other lymph nodes are involved with the tumor [ Designated as safety issue: No ]
  

• Comparison of sentinel lymph node results vs other nodes [ Designated as safety issue: No ]
  
• Comparison of IHC analysis vs standard analysis of the sentinel lymph node [ Designated as safety issue: No ]
  
• Value of intraoperative touch prep analysis of sentinel lymph nodes vs standard pathology [ Designated as safety issue: No ]
  

OBJECTIVES:

Primary

• Evaluate the safety and feasibility of visceral lymphatic mapping using isosulfan blue in patients with adenocarcinoma of the pancreas, colon, stomach, small bowel, or gallbladder.
• Evaluate the ability of surgically defined sentinel lymph nodes to predict whether other lymph nodes in the basin are involved with the tumor in these patients.

Secondary

• Compare the results obtained from the sentinel lymph node (i.e., positive or negative for metastatic disease) with the results obtained from the other nodes in these patients.
• Compare immunohistochemical analysis with standard analysis of the sentinel lymph nodes in these patients.
• Evaluate the value of intraoperative touch prep analysis of sentinel lymph nodes in these patients.

OUTLINE: This is a pilot study.

During surgical resection of the primary tumor, patients receive isosulfan blue subcutaneously 5 minutes before undergoing sentinel lymph node identification/excision and radical lymphadenectomy. Tissue samples are analyzed by IHC for cytokeratins and CEA.