The role of laparoscopy in surgical treatment of pancreatic cancer

AIM: The authors reviewed their experience in surgical treatment of pancreatic cancer between 2003-2008. METHODS: Eighty two pancreatic cancer patients (median age 66.7 +/- 12.5) with obstructive jaundice were enrolled in our study: 36 (44%) had an endoscopic biliary stent; 46 patients (56%) were eligible for surgery: 14 received a curative surgery (pancreatoduodenal resection; 4 had a laparoscopic procedure) and 32 patients with non resectable tumor a palliative surgery: 18 had a gastro-jejunal with a biliary anastomosis (in 4 patients the hepatic-jejunal anastomosis was performed in laparoscopy), 6 had a gastro-jejunal anastomosis (2 laparoscopic procedure and 8 patients had only an explorative laparoscopy. RESULTS: The resectability rates was 17.1%. Median age in patients treated with endoscopic biliary stent was significantly higher than those underwent surgery (72.3 +/- 12.2 vs. 63.5 +/- 9.6; p < 0.05). Hospital length of stay in patients underwent radical surgery was significantly higher than those who received palliative surgery (18 +/- 6 vs. 10 +/- 5; p < 0.05). Morbility rate, including operative mortality of .3%, was 15.2%. CONCLUSIONS: Laparoscopy is largerly used in major oncologic surgery for several reasons: it minimized surgical manipulations and so post-operative complications. There is enough scientific evidence of low incidence of post-operative complications and long-term results compared to those achieved with traditional surgery.