Cuschieri A
Department of Surgery, Ninewells Hospital and Medical School, University of Dundee, U.K.
Eur J Surg Oncol. 1988 Feb;14(1):41-4.
The findings in 73 patients undergoing laparoscopy for pancreatic cancer have been reviewed. The procedure was performed immediately prior to a proposed laparotomy which was undertaken in 51 patients. In this subgroup, 42 patients were correctly staged as having incurable/inoperable disease by laparoscopy but only four out of nine patients judged to be resectable were found to be operable at laparotomy. Laparoscopic target biopsy/fine needle cytology of the primary or its secondary deposits confirmed the diagnosis of pancreatic cancer in 61 out of 65 patients (92%). Whereas the majority of hepatic deposits visualized by laparoscopy had been detected by the prelaparoscopic imaging tests, peritoneal and omental deposits were only identified by laparoscopy. Laparoscopy is a useful procedure in the staging of patients with pancreatic cancer and establishes the diagnosis of advanced disease thereby, obviating a laparotomy in all those patients in whom surgical palliation is not indicated. The procedure should be performed in those patients in whom a laparotomy is contemplated.
对73例接受腹腔镜检查的胰腺癌患者的研究结果进行了回顾。该手术紧接在拟进行的剖腹手术之前进行，其中51例患者接受了剖腹手术。在这个亚组中，42例患者经腹腔镜检查被正确分期为患有无法治愈/无法手术的疾病，但在9例被判定为可切除的患者中，只有4例在剖腹手术时被发现可以手术。对原发性或继发性肿瘤进行腹腔镜靶向活检/细针细胞学检查，65例患者中有61例（92%）确诊为胰腺癌。虽然腹腔镜检查发现的大多数肝转移瘤已通过腹腔镜检查前的影像学检查检测到，但腹膜和网膜转移瘤仅通过腹腔镜检查才能发现。腹腔镜检查在胰腺癌患者分期中是一种有用的方法，从而确立晚期疾病的诊断，避免对所有不适合手术姑息治疗的患者进行剖腹手术。该手术应在考虑进行剖腹手术的患者中进行。
