Laparoscopic pancreatic surgery.
BACKGROUND
Potential applications for laparoscopic surgery in pancreatic disease include (1) staging of pancreatic malignancies; (2) palliation of pancreatic malignancies; (3) pancreatic resections for benign and malignant disease; and (4) pancreatic drainage procedures.


METHODS
A review of the literature is presented. In addition, original data on a series of 5 laparoscopic pancreatic distal resections and 10 laparoscopic cystogastrostomies are presented.


CONCLUSIONS
Laparoscopy may have a role in the staging of patients with pancreatic malignancies; however, with high-quality preoperative imaging, the percentage of patients who will benefit from laparoscopy may be as low as 5%. For palliation, both cholecystoenterostomy and choledochoenterostomy can be performed laparoscopically. The former is technically straightforward but has a higher failure rate; the latter is technically difficult and currently not suitable for widespread adoption. Laparoscopic gastroenterostomy is a straightforward means of palliating gastrointestinal obstruction. Patients appear to benefit from laparoscopic distal pancreatic resection but not from laparoscopic pancreaticoduodenectomy. Patients appear to benefit from laparoscopic pseudocyst decompression.
Park
A
A
Department of Surgery, University of Kentucky Chandler Medical Center, Lexington 40536-0298, USA.
Schwartz
R
R
Tandan
V
V
Anvari
M
M
D006801:Humans; D010535:Laparoscopy; D009367:Neoplasm Staging; D010166:Palliative Care; D010180:Pancreatectomy / Q000379:methods; D010182:Pancreatic Diseases / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery; D010192:Pancreatic Pseudocyst / Q000601:surgery