Laparoscopic Exposure of the Pancreas and Staging of Pancreatic Cancer

Laparoscopy combined with laparoscopic contact ultrasonography was recently proposed as a new and effective method for staging and assessment of resectability in pancreatic cancer. In order to limit the occurrence of false-negative findings, the laparoscopic technique should be as close as possible to the equivalent laparotomic procedure. That includes opening of the lesser sac, which is best achieved through an infragastric route, with resulting wide exposure of the pancreatic body and tail. Laparoscopic contact ultrasonography is then performed for the purpose to define tumor limits, study relationships with major vessels, and assess limphnodal invasion. The results of this procedure in a series of 25 patients are discussed in this report. It is concluded that laparoscopic staging of pancreatic cancer is safe and effective in achieving the goal of avoiding unnecessary laparotomies and selecting candidates for surgical resection.