Laparoscopy in the staging of pancreatic cancer

被引:144
作者
Pisters, PWT [1 ]
Lee, JE [1 ]
Vauthey, JN [1 ]
Charnsangavej, C [1 ]
Evans, DB [1 ]
机构
[1] Univ Texas, MD Anderson Canc Ctr, Pancreat Tumor Study Grp, Houston, TX 77030 USA
关键词
D O I
10.1046/j.1365-2168.2001.01695.x
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: Over the past decade, laparoscopy has emerged as a popular method of detecting extrapancreatic metastatic disease in patients presumed to have localized pancreatic cancer. Methods and results: The English language literature on laparoscopic staging of pancreatic cancer was reviewed. Interpretation of this literature on staging laparoscopy is difficult because (1) there has been inconsistent use of high-quality computed tomography (CT) in prospective studies, (2) many studies have included patients with locally advanced disease, and (3) the R-0/R-1/R-2 resection rates among patients staged by laparoscopy have not been reported, making it impossible to correlate laparoscopic findings with the R-0 resection rate. Laparoscopy may prevent unnecessary laparotomy in a proportion of CT-staged patients presumed to have resectable pancreatic cancer. However, routine laparoscopy is performed on patients judged to have resectable disease by high-quality CT, this fraction of patients is between 4 and 13 per cent. Conclusion: When state-of-the-art CT is available, the routine use of staging laparoscopy may not be easily justified from the data in the recent literature. Selective use of laparoscopy may be more appropriate and will probably be a more cost-effective staging approach. Criteria are presented for the selective use of laparoscopy in the staging of patients with localized pancreatic cancer.
引用
收藏
页码:325 / 337
页数:13
相关论文
共 49 条
  • [1] PORTAL-VEIN RESECTION IN PATIENTS UNDERGOING PANCREATICODUODENECTOMY FOR CARCINOMA OF THE PANCREATIC HEAD
    ALLEMA, JH
    REINDERS, ME
    VANGULIK, TM
    VANLEEUWEN, DJ
    DEWIT, LT
    VERBEEK, PCM
    GOUMA, DJ
    [J]. BRITISH JOURNAL OF SURGERY, 1994, 81 (11) : 1642 - 1646
  • [2] Computed tomography and laparoscopy in the assessment of the patient with pancreatic cancer
    Andrén-Sandberg, A
    Lindberg, CG
    Lundstedt, C
    Ihse, I
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 1998, 186 (01) : 35 - 40
  • [3] DIAGNOSTIC LAPAROSCOPY COMBINED WITH LAPAROSCOPIC ULTRASONOGRAPHY IN STAGING OF CANCER OF THE PANCREATIC HEAD REGION
    BEMELMAN, WA
    DEWIT, LT
    VANDELDEN, OM
    SMITS, NJ
    OBERTOP, H
    RAUWS, EJA
    GOUMA, DJ
    [J]. BRITISH JOURNAL OF SURGERY, 1995, 82 (06) : 820 - 824
  • [4] Major vascular resection as part of pancreaticoduodenectomy for cancer: Radiologic, intraoperative, and pathologic analysis
    Bold, RJ
    Charnsangavej, C
    Cleary, KR
    Jennings, M
    Madary, A
    Leach, SD
    Abbruzzese, JL
    Pisters, PWT
    Lee, JE
    Evans, DB
    [J]. JOURNAL OF GASTROINTESTINAL SURGERY, 1999, 3 (03) : 233 - 243
  • [5] BRESLIN TA, 2000, IN PRESS ANN SURG ON
  • [6] Staging laparoscopy with laparoscopic ultrasonography: Optimizing resectability in hepatobiliary and pancreatic malignancy
    Callery, MP
    Strasberg, SM
    Doherty, GM
    Soper, NJ
    Norton, JA
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 1997, 185 (01) : 33 - 39
  • [7] The value of minimal access surgery in the staging of patients with potentially resectable peripancreatic malignancy
    Conlon, KC
    Dougherty, E
    Klimstra, DS
    Coit, DG
    Turnbull, ADM
    Brennan, MF
    [J]. ANNALS OF SURGERY, 1996, 223 (02) : 134 - 140
  • [8] SURVIVAL IN 1001 PATIENTS WITH CARCINOMA OF THE PANCREAS
    CONNOLLY, MM
    DAWSON, PJ
    MICHELASSI, F
    MOOSSA, AR
    LOWENSTEIN, F
    [J]. ANNALS OF SURGERY, 1987, 206 (03) : 366 - 373
  • [9] CUSCHIERI A, 1988, EUR J SURG ONCOL, V14, P41
  • [10] CUSHIERI A, 1978, GUT, V19, P672