Röthlin M
Klinik für Viszeralchirurgie, Universitätsspital Zürich.
Swiss Surg. 1996;Suppl 4:25-8.
The dismal prognosis of pancreatic cancer and the development of new, minimally invasive bypass techniques require a differentiated indication for open pancreatic resection. Diagnostic modalities, which facilitate an accurate assessment of resectability, have to be found. Modern imaging and endoscopic techniques fullfill these requirements in only about 50% of cases. Diagnostic laparoscopy is the only method for visualization of peritoneal metastases. The use of diagnostic laparoscopy and laparoscopic sonography raises the resectability rate to between 75% and 100%. 33% up to 67% of patients deemed resectable by preoperative imaging show signs of irresectable cancer at laparoscopy and can be spared a negative laparotomy. These patients can be treated by laparoscopic or endoscopic bypass techniques.
胰腺癌预后不佳，新型微创旁路技术的发展要求对开放性胰腺切除术有明确的指征。必须找到有助于准确评估可切除性的诊断方法。现代影像学和内镜技术仅在约50%的病例中满足这些要求。诊断性腹腔镜检查是唯一可观察腹膜转移的方法。使用诊断性腹腔镜检查和腹腔镜超声可将可切除率提高到75%至100%。术前影像学检查认为可切除的患者中，有33%至67%在腹腔镜检查时显示出不可切除癌症的迹象，可避免进行阴性剖腹探查。这些患者可通过腹腔镜或内镜旁路技术进行治疗。
