Preoperative Laparoscopic Examination Using Surgical Manipulation and Ultrasonography for Pancreatic Lesions

Abstract

LUS, when combined with laparoscopic manipulations, may overcome many of the limitations of laparoscopy alone in the investigation of pancreatic lesions by providing an accurate diagnosis and assessment of the size and extent of the local dissemination.

Peripancreatic tuberculosis mimicking pancreatic neoplasia

“…Peripancreatic TB usually falls into one of four distinct clinical scenarios: the infection may (1) produce pancreatitis, 8 (2) cause obstructive jaundice, 5,9 (3) lead to GI bleeding, 10 or as in the present case, (4) mimic pancreatic neoplasia as a discrete mass. 7,[11][12][13][14][15][16][17][18][19] This final presentation, the most common of the four, serves as the focus of the remaining discussion.…”

A rare diagnosis for a pancreatic mass: splenosis

“…5 Laparoscopic examination, with ultrasonography, provides an accurate differential diagnosis of the pancreatic masses, with assessment of the size and the extent of the local dissemination. 7 In our case, the octeotride scan suggested the presence of an endocrine tumor of the pancreas, despite the fact that the gastrointestinal hormones, serum values were within normal ranges. In this unclear situation, we performed a diagnostic laparoscopy, with a careful exploration and histopathologic examination of the surgical specimens, which enabled accurate diagnosis.…”

The role of laparoscopy and laparoscopic ultrasound in the preoperative staging of pancreatico-biliary cancers – A meta-analysis

“…80% of articles extracted were review articles, whilst the remaining did not assess SL/LUS as staging modality. Of the remaining 41 articles, 12 studies did not satisfy the eligibility criteria; 22 were for potentially resectable PPC and 7 for PBC [10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37] (Supplemental information, Table ST1 to attain pneumoperitoneum and were therefore excluded from our analysis. Therefore, a total of 2,827 patients with PPC and 478 patients with PBC, deemed potentially resectable on preoperative staging, were included for analysis.…”

“…The mortality and morbidity attributed to the use of laparoscopy in potentially resectable pancreatico-biliary cancers (PPC & PBC) was reported by 9 of the 29 studies included in our analysis [13,14,15,16,17,18,19,20,21]: haemorrhage requiring laparotomy (n=3), port site abscess/infection (n=3), post operative pneumonia (n=2), post procedure pancreatitis (n=2), bile leak (n=2), port site haematoma (n=2), port site recurrence (n=1).…”