A critical appraisal of laparoscopic staging in hepatobiliary and pancreatic malignancy

Prognosis for patients with hepatobiliary and pancreatic cancers is dismal. Surgery is the best therapeutic option for those with tumors which have no t yet metastasized. Standard radiologic tests such as computed tomography ( CT) scan and trans-abdominal ultrasound are useful in identifying patients for whom an attempt at resection would be futile. Staging laparoscopy with laparoscopic ultrasound allows greater precision in identifying those for w hom resection would he helpful with less morbidity than an open exploration . Metastatic disease can be identified more precisely than with radiologic tests and can be characterized by biopsy techniques. Palliative procedures are now being performed laparoscopically with low morbidity and short hospi tal stays. The use of laparoscopy prior to open exploration for patients wi th hepatobiliary and pancreatic tumors is advantageous. (C) 2001 Elsevier S cience Ltd. All rights reserved.