ABSTRACT
For patients with adenocarcinoma of the pancreas the outlook remains bleak despite recent advances in diagnosis and treatment.1*2 The American Cancer Soci ety has estimated that 27,000 new cases will be diagnosed in the United States during 1997.3 The majority of these patients will die o f their disease within a year o f diagnosis, making it the fourth leading cause of cancer death in men and the fifth in women. Non-specificity of symptoms, advanced disease at presentation, lack o f effective adjuvant and systemic therapy help explain this grim prognosis. At present, surgical resection for localized disease offers the only chance for long term survival.2,4*7
Unfortunately, the majority o f patients continue to present with advanced dis ease.8,9 Due to the inability o f sophisticated diagnostic modalities such as com puterized tomography (CT), magnetic resonance imaging (M RI) and ultrasound (US) to accurately assess the extent o f disease, many of these patients will still undergo surgical exploration for accurate staging or palliation.8,9 For those in whom an open palliative procedure is not warranted, exploration confers no benefit, and may be associated with significant morbidity and mortality affecting both the quality and duration o f survival.10,11
It has been recently argued that minimal access surgical techniques have much to offer patients with adenocarcinoma of the pancreas from both the diagnostic/ staging and palliative perspective. This chapter will review the role o f laparoscopy in both o f these areas.
