EXPLORATIVE LAPAROTOMY OR LAPAROSCOPY IN PATIENTS WITH CARCINOMA OF THE STOMACH AND PANCREAS

The remaining lifetime of patients with inoperable carcinoma of the st omach or pancreas is limited, and an explorative laparotomy performed only to confirm unresectability causes unnecessary emotional and physi cal stress to the patients. As an alternative we have for the last 18 months performed a laparoscopy in these patients and recorded complica tions, length of hospital stay and post-operative survival. For compar ison we have retrospectively studied the records of similar patients w ho went through explorative laparotomy during the previous 3 years. La paroscopy was found to reduce the number of post-operative complicatio ns, decrease the length of hospital stay and, when compared with lapar otomy, increase the median remaining lifetime by more than 100% (P < 0 .01). To reduce the number of futile laparotomies in patients with inc urable carcinoma of the stomach or pancreas, laparoscopy should be per formed as an integrated part of the pre-operative assessment procedure s.