[Efficacy and economic aspects of preoperative diagnosis: laparoscopy is useful in only 13% of patients with pancreatic carcinoma].

The value of diagnostic laparoscopy to improve tumor staging in patients with pancreatic and periampullary cancer is still a matter of controversial discussion, especially with regard to whether diagnostic laparoscopy can identify patients in whom a laparotomy can be avoided due to metastases. To answer this question, all patients who underwent operations for pancreatic cancer (n = 97) or periampullary cancer (n = 30) between 11/1993 and 12/1995 were evaluated. Only 10% of the patients with periampullary/pancreatic cancer and 13% with pancreatic cancer could avoid laparotomy through diagnostic laparoscopy. Due to these low numbers, a diagnostic laparotomy cannot be recommended in general in patients with pancreatic and/or periampullary cancer on economic grounds and because of the risk of trocar metastases.