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Laparoscopic palliation of unresectable pancreatic cancers: preliminary results
M Casaccia1, P Diviacco, P Molinello
1Department of Emergency Surgery, University of Genoa, Italy.
Objective:
To assess the feasibility of laparoscopic gastroenteric and cholecystenteric bypass procedures for palliation of inoperable cancer of the pancreas.
Design:
Prospective study.
Setting:
Teaching hospital, Italy.
Subjects:
6 patients (4 men and 2 women, range 53-72 years, median 64) who presented between July 1995 and April 1997 with inoperable pancreatic cancer.
Interventions:
Laparoscopic gastroenterostomy for duodenal obstruction. Four patients had already had endoscopic biliary decompression. 2 patients also had laparoscopic cholecystojejunostomy for biliary obstruction at the time of the laparoscopic gastroenterostomy.
Main Outcome Measures:
Morbidity and mortality.
Results:
The procedure was completed laparoscopically in all patients. There was no perioperative mortality and morbidity was low (1 bleeding from the drain and 1 paralytic ileus). The median postoperative stay was 4.5 days (range 4-6).
Conclusions:
Laparoscopic gastroenterostomy, together with cholecystojejunostomy in selected patients with inoperable pancreatic cancer, offers a less invasive alternative to open surgery with a short hospital stay and rapid return to normal activity.