The role of diagnostic laparoscopy in detecting minimal peritoneal metastatic deposits in patients with pancreatic cancer scheduled for curative resection.

Background: Pancreatic cancer (PC) is an aggressive disease usually diagnosed at an advanced stage. Modern computed tomography can define the subgroup of operable patients. However, minimal peritoneal deposits can be undetected even by modern computed tomography protocols. Aim: To diagnose those patients who are not operable because of a peritoneal spread using diagnostic laparoscopy (DL), thus avoiding unnecessary laparotomies. Methods: A retrospective study was conducted on 52 consecutive patients with PC scheduled for curative pancreatic surgery. Results: Out of 52 patients who underwent DL, peritoneal spread was diagnosed in 5 patients and these patients were denied surgery. Laparoscopy did not detect 2 other patients with peritoneal spread. Conclusions: Although the added value of DL in patients with PC is small (around 10% in our series), considering the minimal morbidity and costs attributed to this procedure, we believe that it should be adopted as a routine approach.