Endovascular interventions of the CFA/DFA have a low rate of periprocedural morbidity and mortality. One-year patency is lower than historically observed for CFA endarterectomy. Stent use is associated with reinterventions and amputation. Longer-term analysis is needed to better assess durability.

Although it was used in only 1 in 10 cases of percutaneous EVAR, LA was associated with fewer pulmonary complications after adjustment for patient factors. Surgeons should consider expanding the use of LA for percutaneous EVAR when feasible.

Background Routine preoperative staging in pancreas cancer is controversial. We sought to evaluate the rates of diagnostic laparoscopy (DLAP) for pancreatic cancer. Methods We queried the National Surgical Quality Improvement Program for patients with pancreas cancer (2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013) and compared groups who underwent DLAP, exploratory laparotomy (XLAP), pancreas resection (RSXN) or therapeutic bypass (THBP). We compared demographics, comorbidities, postoperative complications, 30-day mortality (Chi-square P \ 0.05) and trends over time (R 2 0-1). Results We identified 17,138 patients (RSXN 81.8%, XLAP 16.5%, THBP 8.2%, and DLAP 12.9%), with some having multiple CPT codes. Only 10.3% (n = 1432) of RSXN patients underwent DLAP prior to resection. XLAP occurred in 49.5% of non-RSXN patients, of whom 67.1% had no other operation. The percentage of patients undergoing RSXN increased 20.3% over time (R 2 0.81), while DLAP decreased 52.6% (R 2 0.92). XLAP patients without other operations decreased from 4.2 to 2.4%, although not linearly (R 2 0.31). Only 10.3% of XLAP had a diagnostic laparoscopy as well, leaving nearly 90% of these patients with an exploratory laparotomy without RSXN or THBP. Discussion Diagnostic laparoscopy for pancreas malignancy is becoming less common but could benefit a subset of patients who undergo open exploration without resection or therapeutic bypass.