Improved tumor staging by diagnostic laparoscopy

This study was performed to assess the role of additional diagnostic laparo scopy in the preoperative staging of patients with adenocarcinoma of the es ophagus, gastric cancer and pancreatic cancer prior to intended curative su rgery. 89 patients with primary solid abdominal tumors were eligible for evaluatio n; of those 49 patients had a gastric cancer, 33 a pancreatic cancer and se ven an adenocarcinoma of the esophagus. Patients without histologically pro ven metastases proceeded to laparotomy. Metastases were detectable laparoscopically in nine of 49 patients (18.4%) with gastric cancer (peritoneum n = 5, omentum n = 2, liver n = 2). Intraop eratively metastases were evident in further five cases (liver n = 3, perit oneum n = 2). In eleven of 33 patients (33%) with pancreatic cancer metasta ses were detected by laparoscopy (liver n = 6, peritoneum n = 2, liver and peritoneum n = 3) and in further four patients intraoperativell; (liver n = 2, peritoneum n = 2). One of seven patients with an adenocarcinoma of the esophagus had liver metastases detected by laparoscopy. Intraoperatively no metastases were evident in those patients. Laparotomies were avoidable in 21 of the 89 patients (23.6%) who had a diagnostic laparoscopy prior to int ended curative resection. Preoperative staging by additional diagnostic laparoscopy proved effective in patients with gastric and pancreatic cancer.