Laparoscopic evaluation in pancreatic cancer

Nipun B. Merchant, Kevin C. Conlon

Research output: Contribution to journalReview article

34 Scopus citations

Abstract

Pancreatic cancer continues to carry a poor overall prognosis. The majority of patients have advanced disease at the time of presentation. Dynamic, contrast-enhanced computed tomography (CT) has become the radiographic study of choice in the pre-operative staging of patients with pancreatic cancer. While it has been shown to be highly sensitive in determining unresectability of peri-ampullary tumors, the ability of CT to predict accurately which tumors can be safely resected is still limited. Laparoscopic staging of peri-ampullary tumors is superior to dynamic CT in visualizing small liver and peritoneal metastases. The addition of laparoscopic ultrasound during laparoscopic staging enhances the ability of laparoscopy to determine resectability of these tumors and approaches the accuracy of open exploration without increasing significant morbidity or mortality. Patients who are deemed unresectable at the time of laparoscopy can undergo palliative biliary and/or gastric bypass procedures laparoscopically and further minimize the morbidity of laparotomy.

Original languageEnglish (US)
Pages (from-to)155-165
Number of pages11
JournalSeminars in Surgical Oncology
Volume15
Issue number3
DOIs
StatePublished - Oct 1 1998
Externally publishedYes

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Keywords

  • Adenocarcinoma
  • Angiography
  • Biliary tract surgical procedures
  • Biliopancreatic diversion
  • Biopsy
  • Cholecystostomy
  • Cholestasis
  • Cost-benefit analysis
  • Drainage
  • Endoscopic retrograde cholangiopancreatography
  • Extrahepatic bile duct obstruction
  • Gastric bypass
  • Jejunostomy
  • Laparoscopic surgical procedures
  • Laparoscopy
  • Magnetic resonance imaging
  • Neoplasm staging
  • Palliative care
  • Pancreatic neoplasms
  • Quality of life
  • Sensitivity and specificity
  • Stents
  • Stomach/surgery
  • Surgical anastomosis
  • Treatment outcome
  • Ultrasonography
  • X-ray computed tomography

ASJC Scopus subject areas

  • Surgery
  • Oncology

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