Faculty Collaboration Database

Laparoscopy in the staging of pancreatic cancer. Br J Surg 2001 Mar;88(3):325-37

Date

03/22/2001

Pubmed ID

11260096

DOI

10.1046/j.1365-2168.2001.01695.x

Scopus ID

2-s2.0-0035074569 (requires institutional sign-in at Scopus site)   214 Citations

Abstract

BACKGROUND: Over the past decade, laparoscopy has emerged as a popular method of detecting extrapancreatic metastatic disease in patients presumed to have localized pancreatic cancer.

METHODS AND RESULTS: The English language literature on laparoscopic staging of pancreatic cancer was reviewed. Interpretation of this literature on staging laparoscopy is difficult because (1) there has been inconsistent use of high-quality computed tomography (CT) in prospective studies, (2) many studies have included patients with locally advanced disease, and (3) the R0/R1/R2 resection rates among patients staged by laparoscopy have not been reported, making it impossible to correlate laparoscopic findings with the R0 resection rate. Laparoscopy may prevent unnecessary laparotomy in a proportion of CT-staged patients presumed to have resectable pancreatic cancer. However, routine laparoscopy is performed on patients judged to have resectable disease by high-quality CT, this fraction of patients is between 4 and 13 per cent.

CONCLUSION: When state-of-the-art CT is available, the routine use of staging laparoscopy may not be easily justified from the data in the recent literature. Selective use of laparoscopy may be more appropriate and will probably be a more cost-effective staging approach. Criteria are presented for the selective use of laparoscopy in the staging of patients with localized pancreatic cancer.

Author List

Pisters PW, Lee JE, Vauthey JN, Charnsangavej C, Evans DB

Author

Douglas B. Evans MD Chair, Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Cost-Benefit Analysis
Humans
Laparoscopy
Male
Neoplasm Staging
Palliative Care
Pancreatic Neoplasms
Prospective Studies
Tomography, X-Ray Computed
Ultrasonography, Interventional