[Efficacy and economic aspects of preoperative diagnosis: laparoscopy is useful in only 13% of patients with pancreatic carcinoma].
The value of diagnostic laparoscopy to improve tumor staging in patients with pancreatic and periampullary cancer is still a matter of controversial discussion, especially with regard to whether diagnostic laparoscopy can identify patients in whom a laparotomy can be avoided due to metastases. To answer this question, all patients who underwent operations for pancreatic cancer (n = 97) or periampullary cancer (n = 30) between 11/1993 and 12/1995 were evaluated. Only 10% of the patients with periampullary/pancreatic cancer and 13% with pancreatic cancer could avoid laparotomy through diagnostic laparoscopy. Due to these low numbers, a diagnostic laparotomy cannot be recommended in general in patients with pancreatic and/or periampullary cancer on economic grounds and because of the risk of trocar metastases.
Friess
H
H
Klinik für Viszerale und Transplantationschirurgie, Universität Bern, Inselspital.
Baer
H U
HU
Sadowski
C
C
Büchler
M W
MW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater / Q000473:pathology / Q000601:surgery; D003138:Common Bile Duct Neoplasms / Q000191:economics / Q000473:pathology / Q000601:surgery; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000191:economics*; D008297:Male; D008875:Middle Aged; D009366:Neoplasm Seeding; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000191:economics / Q000473:pathology* / Q000601:surgery; D012307:Risk Factors; D012680:Sensitivity and Specificity
Effizienz und Okonomie der präoperativen Diagnostik: Die Laparoskopie ist nur bei 13% der Patienten mit Pankreaskarzinom sinnvoll.