Diagnostic laparoscopy for periampullary and pancreatic cancer: What is the true benefit?

Christopher J. Barreiro, Keith D. Lillemoe, Leonidas G. Koniaris, Taylor A. Sohn, Charles J. Yeo, Jo Ann Coleman, Elliot K. Fishman, John L. Cameron

    Research output: Contribution to journalArticlepeer-review

    62 Scopus citations

    Abstract

    The role of diagnostic laparoscopy in patients with periampullary and pancreatic malignancies is controversial. A retrospective review was performed including all patients (n = 188) with a periampullary or pancreatic malignancy who underwent both CT and laparotomy at our institution between January 1997 and December 1999. The overall resectability rate for all periampullary cancers was 67.3% (115 of 171 patients). This compared favorably with the resectability rate for cancers of the pancreatic body and tail (3 of 17 patients, 17.6%; P < 0.01 vs. periampullary cancers). Fifty percent of patients with periampullary cancers were unresectable because of metastatic disease, whereas metastatic disease precluded resection in 64.3% of patients with cancers of the pancreatic body and tail. After patients undergoing operative palliation were eliminated, a nontherapeutic laparotomy would have been precluded by the use of diagnostic laparoscopy in only 2.3% of patients with periampullary cancers (4 of 171 patients). In contrast, 6 (35.3%) of 17 patients with cancers of the pancreatic body and tail underwent a nontherapeutic laparotomy (P < 0.01 vs. periampullary cancers). One hundred fifty-eight (84%) of the 188 CT reports reviewed could be definitively categorized as either "likely to be resectable" or "likely to be unresectable." The remaining 16% were equivocal. Of the 107 patients categorized as likely to be resectable, 89 were actually resected (83.2%). In contrast, only 10 of the 51 patients categorized as likely to be unresectable could be resected (19.6%).

    Original languageEnglish (US)
    Pages (from-to)75-81
    Number of pages7
    JournalJournal of Gastrointestinal Surgery
    Volume6
    Issue number1
    DOIs
    StatePublished - Jan 1 2002

    Keywords

    • Diagnostic laparoscopy
    • Pancreatic cancer
    • Periampullary cancer

    ASJC Scopus subject areas

    • Surgery
    • Gastroenterology

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