The role of laparoscopy in advanced pancreatic cancer diagnosis.

Abstract

BACKGROUND/AIMS:

Histological diagnosis between ductal and endocrine carcinoma is imperative in patients with advanced and unresectable pancreatic malignancies because of the different treatment modalities and prognoses. Whenever percutaneous and endoscopic ultrasound-guided pancreatic fine needle aspiration (FNA) fails to obtain a diagnostic specimen, a laparoscopic approach may be employed.

METHODS:

Between October 2002 and July 2004, 19 patients with demonstrated unresectable pancreatic cancer underwent laparoscopy to obtain a cytohistological diagnosis.

RESULTS:

The mean operative time was 83 min. Laparoscopy showed the presence of liver metastases in 15 patients that were correctly diagnosed by preoperative imaging in only 8 cases (53%). Overall 5 pancreatic FNA and 16 liver and peritoneal biopsies were obtained. In 1 patient the procedure was abandoned due to hypercapnia. In 16 patients (84%) a cytohistological diagnosis was obtained. There were no mortalities.

CONCLUSIONS:

Laparoscopic biopsy of advanced unresectable pancreatic cancer is a feasible, safe and reliable procedure to obtain a cytohistological diagnosis whenever ultrasound-guided FNA fails.

• Authors: Giovanni Butturini, Stefano Crippa, Claudio Bassi, Roberto Salvia, Micaela Piccoli, Paolo Pederzoli
• Journal: Digestive surgery (Dig Surg) Vol. 24 Issue 1 Pg. 33-7 ( 2007) ISSN: 0253-4886 [Print] Switzerland
• PMID: 17369679 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright (c) 2007 S. Karger AG, Basel

Topics

• Adult
• Aged
• Biopsy (methods)
• Feasibility Studies
• Female
• Humans
• Insufflation
• Laparoscopy
• Liver Neoplasms (secondary)
• Male
• Middle Aged
• Neoplasm Staging
• Pancreatic Neoplasms (pathology, surgery)