Role of laparoscopy and laparoscopic ultrasound in staging of pancreatic tumours.
OBJECTIVE
Radiological imaging alone is not reliable enough in staging of pancreatic cancer. Not only because of poor sensitivity but also because there is a tendency to overstage tumours. The aim of the study was to compare the efficiency of spiral computed tomography (CT), transabdominal ultrasound (US), laparoscopy (LAP) and laparoscopic ultrasound (LUS) in staging of pancreatic tumours.


METHODS
In this prospective study 27 patients underwent pancreatic tumour staging with CT, US, LAP and LUS. The reference standard was operative evaluation or in case of disseminated disease laparoscopic assessment.


CONCLUSIONS
Although LAP was hindered by adhesions in 11% of the patients the benefit of LAP staging was evident in detecting peritoneal carcinomatosis. The assessment of the local tumour expansion of a pancreatic carcinoma was difficult for all staging modalities. LUS did not change the decision whether to proceed with laparotomy once. In our experience routine use of laparoscopic staging does not benefit patients with pancreatic tumour but in selected cases it may prevent unnecessary laparotomy.
Lavonius
M I
MI
Department of Surgery, Turku University Central Hospital, Finland. maija.lavonius@tyks.fi
Laine
S
S
Salo
S
S
Sonninen
P
P
Ovaska
J
J
D000328:Adult; D000368:Aged; D019160:Endosonography; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D011237:Predictive Value of Tests; D011446:Prospective Studies