Croce Enrico, Olmi Stefano, Bertolini Aimone, Magnone Stefano
Second Department of General Surgery, Center of Minimally Invasive Surgery, Ospedale S Gerardo, Monza (MI), Italy.
Hepatogastroenterology. 2005 Nov-Dec;52(66):1889-94.
The use of laparoscopy in pancreatic cancer offers a significant contribution to the diagnosis and treatment of this disease. Both laparoscopic staging and treatment of pancreatic cancer have proved feasible and effective. This paper reviews the literature on this topic, by a Medline search using the words laparoscopy and pancreas. Various aspects are considered: staging, treatment and palliation. Cross-references from the articles retrieved were reviewed. The efficacy and safety of diagnostic laparoscopy and ultrasonography, lowering the rate of useless laparotomies, is evident in most studies. Moreover laparoscopic resection of the body and tail of the pancreas, as well as palliation of digestive obstruction has been demonstrated as feasible. Controversy exists on feasibility of pancreatoduodenectomy. Laparoscopic gastric outlet obstruction bypass and laparoscopic biliary decompression have been reported with good results compared to open surgical procedures. Randomized controlled trials are required to validate promising results coming from the reported series, mainly retrospective.
腹腔镜检查在胰腺癌的诊断和治疗中发挥着重要作用。腹腔镜分期及治疗胰腺癌已被证明是可行且有效的。本文通过使用“腹腔镜检查”和“胰腺”等关键词在Medline数据库进行检索，对该主题的文献进行综述。文中考虑了多个方面：分期、治疗及缓解症状。对检索到的文章的参考文献也进行了回顾。多数研究表明，诊断性腹腔镜检查及超声检查的有效性和安全性显著，可降低不必要剖腹手术的发生率。此外，腹腔镜下胰腺体尾部切除术以及消化道梗阻的缓解治疗也已被证明是可行的。胰十二指肠切除术的可行性存在争议。与开放手术相比，腹腔镜下胃出口梗阻旁路手术及腹腔镜胆道减压术已报道取得了良好效果。需要进行随机对照试验来验证这些主要为回顾性报道系列所取得的有前景的结果。
