Computed Tomography and Laparoscopy in the Assessment of the Patient With Pancreatic Cancer

Value of laparoscopic staging for upper gastrointestinal malignancies

“…In order to assess the economic impact of introducing laparoscopic staging at our institution, we recently completed a prospective study that compared hospital charges for patients who underwent a laparoscopic procedure whether or not they had a subsequent open operation to a group of patients who underwent an open operation alone. Overall charges were 25% lower in the laparoscopic group (data not shown), which is similar to retrospective studies from other centers in the United States and Europe [9,10]. In contrast, some authors have argued that even if the percentage of patients who would benefit from laparoscopic staging is in the range of 10%-20%, this incremental yield over existing state-of-the-art radiology is limited and thus intuitively not a cost-effective utilization of available resources [11].…”

The role of laparoscopy and laparoscopic ultrasound in the preoperative staging of pancreatico-biliary cancers – A meta-analysis

“…80% of articles extracted were review articles, whilst the remaining did not assess SL/LUS as staging modality. Of the remaining 41 articles, 12 studies did not satisfy the eligibility criteria; 22 were for potentially resectable PPC and 7 for PBC [10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37] (Supplemental information, Table ST1 to attain pneumoperitoneum and were therefore excluded from our analysis. Therefore, a total of 2,827 patients with PPC and 478 patients with PBC, deemed potentially resectable on preoperative staging, were included for analysis.…”

Technique and Value of Staging Laparoscopy

“…Resection rates are reported to be as high as 75–92% [28]. The experience of SL combined with ultrasonography in the staging of pancreatic cancer is summarized in table 3 [5, 29, 30, 31]. …”