Pancreatic Biopsy under Visual Control in Conjunction with Laparoscopy for Diagnosis of Pancreatic Cancer

Watanabe, Makoto; Takatori, Yoshimasa; Ueki, Kazunori; Umekawa, Yasuhiro; Yoshida, Hikaru; Kobatake, Tsutomu; Hirakawa, Hiroyasu; Fukumoto, Shiro; Shimada, Yoshihiro

doi:10.1055/s-2007-1012912

Cited by 10 publications

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“…19 Inspection and LUS imaging of the body and tail of the pancreas, as well as the mesenteric vessels and celiac lymph nodes, has traditionally been achieved via either a supra-or infragastric approach. 5,6,[20][21][22] The supragastric approach can be somewhat limited in obese patients and in those with lesser sac adhesions. The infragastric approach is somewhat more technically challenging, but is achievable in most patients.…”

Section: Diagnostic Laparoscopy and Staging Of Pancreatic Lesionsmentioning

confidence: 99%

Current status of laparoscopic surgery of the pancreas

Underwood

Soper

1999

Journal of Hepato-Biliary-Pancreatic Surgery

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Laparoscopic surgery of the pancreas remains, other than for certain clear indications, primarily investigational. However, in the past few years, laparoscopic therapy for pancreatic diseases has made significant strides and will undoubtedly contribute increasingly to the care of the surgical patient with pancreatic disease. This review discusses the current status of minimally invasive surgical therapy of pancreatic diseases and reviews the current literature. There are four major areas of clinical and laboratory investigation, including diagnostic laparoscopy for staging of pancreatic cancer, laparoscopic palliation of unresectable pancreatic cancer, laparoscopic management of pancreatic pseudocyst, and laparoscopic partial pancreatectomy (pancreaticoduodenectomy, distal pancreatectomy, and enucleation for islet cell tumors). The increased sensitivity of staging laparoscopy with laparoscopic ultrasound as a staging modality in the diagnosis of previously unrecognized metastatic disease from pancreatic cancer is clearly the most utilitarian application of laparoscopic technology in this patient population. Additionally, a natural extension of staging laparoscopy with laparoscopic ultrasound is the ability to improve the quality of life for the patient with unresectable pancreatic cancer by palliating the biliary and gastrointestinal obstruction and the debilitating pain, without the need for and morbidity of open laparotomy. Laparoscopic internal drainage of pancreatic pseudocysts remains early in its development but appears to have potential benefit from application of minimal access techniques. And laparoscopic partial pancreatectomy, both pancreaticoduodenectomy, and, to a lesser degree, distal pancreatectomy, remain primarily investigational without clearly established benefits from the use of minimal access techniques.

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