Il ruolo della laparoscopia nel trattamento chirurgico del carcinoma pancreatico


COD: 04_2010_295-300 Categorie: ,

Paolo Ialongo, Filippo Ferrarese, Oronzo Pannarale, Annunziata Panebianco, Annalisa Volpi, Nicola Palasciano

Ann. Ital. Chir., 2010; 81: 295-299

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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.