Laparoscopy for pancreatic cancer: does it benefit the patient?

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.