PMID: 9632157Jun 19, 1998Paper

The role of diagnostic laparoscopy in pancreatic and periampullary malignancies

Journal of the American College of Surgeons
H FriessMarkus W Büchler

Abstract

The role of diagnostic laparoscopy before laparotomy in patients with pancreatic or periampullary malignancies remains controversial. We analyzed the value of using diagnostic laparoscopy to avoid laparotomy in these patients. Between November 1993 and December 1996, 254 patients with pancreatic or periampullary malignancies were treated. In 74 patients, multiple distant metastases precluded further surgical treatment. In all, 180 patients underwent laparotomy for pancreatic cancer (119 patients) or periampullary cancer (61 patients). Preoperatively, all patients underwent computed tomography for staging and to assess resectability of the tumor. Based on the results of the imaging procedure, the patients were scheduled for either tumor resection or a palliative operation. Twenty-one of 180 patients (12%) with pancreatic or periampullary malignancies were scheduled preoperatively for nonresectional operations because of distant metastasis or retroperitoneal tumor infiltration. In none of these patients was the operative strategy changed. In 159 of 180 patients (88%), a pancreatic resection was planned preoperatively; 119 patients underwent pancreatic resection. In the remaining 40 patients preoperatively scheduled for tumor rese...Continue Reading

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