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Annals of Oncology Advance Access published online on October 19, 2005
Annals of Oncology, doi:10.1093/annonc/mdj013
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© 2005 European Society for Medical Oncology
Received May 5, 2005
Revised August 1, 2005
Accepted August 2, 2005

review

The current role of staging laparoscopy for adenocarcinoma of the pancreas: a review

D. Stefanidis 1, K. D. Grove 2, W. H. Schwesinger 2, and C. R. Thomas Jr3*

1 Tulane Center for Minimally Invasive Surgery, Tulane University Health Sciences Center, New Orleans, LA, USA
2 Department of Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
3 Department of Radiation Medicine, Oregon Health and Science University, Portland, OR, USA

* To whom correspondence should be addressed.
C. R. Thomas Jr, E-mail: cthomas{at}ctrc.net


  Abstract

In the absence of metastatic disease patients with localized or locally advanced pancreatic cancer can benefit from surgical resection or chemoradiation. Despite the advances of imaging technology, however, noninvasive staging modalities are still inaccurate in identifying small volume metastatic disease leading potentially to inappropriate treatment and avoidable morbidity in a subgroup of patients. Staging laparoscopy may identify those patients with unsuspected metastatic disease on preoperative imaging and prevent unnecessary laparotomy or chemoradiation. A controversy exists, however, as to whether the procedure should be used routinely or selectively in pancreatic cancer patients with no evidence of metastasis on noninvasive staging. This review aims to assess the current role of staging laparoscopy by examining its diagnostic accuracy and ability to prevent unnecessary treatment as well as its morbidity, oncologic effect and cost-effectiveness. The available literature will be evaluated critically, its limitations identified and exisiting controversies addressed.

Keywords: laparoscopy; pancreatic cancer; staging; surgery.
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