[Diagnostic laparoscopy and laparoscopic ultrasonography: value of staging and assessment of resectability of pancreatic carcinoma]

Abstract

The dismal prognosis of pancreatic cancer and the development of new, minimally invasive bypass techniques require a differentiated indication for open pancreatic resection. Diagnostic modalities, which facilitate an accurate assessment of resectability, have to be found. Modern imaging and endoscopic techniques fullfill these requirements in only about 50% of cases. Diagnostic laparoscopy is the only method for visualization of peritoneal metastases. The use of diagnostic laparoscopy and laparoscopic sonography raises the resectability rate to between 75% and 100%. 33% up to 67% of patients deemed resectable by preoperative imaging show signs of irresectable cancer at laparoscopy and can be spared a negative laparotomy. These patients can be treated by laparoscopic or endoscopic bypass techniques.