LAPAROSCOPIC OBSERVATION OF RANCREATIC CANCER

Abstract

Laparoscopic examinations were performed in 30 patients with pancreatic cancer and 7 patients with chronic pancreatitis. As to the method of pancreatic observation, a supragastric method was chosen in the cases of pancreatic cancer in the body and / or tail and chronic pancreatitis. The results obtained as were follows: 1) In all 16 cases except one with pancreatic cancer in the head, the greenish liver accompanied by enlarged gallbladder was observed. In such cases of obvious obstructive cholestasis, endoscopic detection of intraperitoneal metastasis was mainly conducted, instead of unnecessary observation of pancreas itself. 2) Observation of the pancreas was succeeded in 10 out of 11 cases with pancreatic cancer in the body and / or taro (91%), and in 4 out of 7 cases with chronic pancreatitis (57%). Three cases were not tried to observe pancreas, because the liver metastasis was obvious. 3) In both chronic pancreatitis and pancreatic cancer which had not invaded the pancreas capsule yet, the pancreas appeared increasing in its white color tone and in its consistency. 4) In pancreatic cancer which had already invaded the capsule, findings of vascular stenosis and cut off of fine vessels on the pancreatic surface were observed. In pancreatic cancer which had not invaded the capsule yet, however, endoscopic differenti-ation from chronic pancreatitis seemed almost impossible. 5) An aspiretion biopsy of the pancreas by a fine needle was proved as very useful procedure for the differential diagnosis between pancreatic cancer and chronic pancreatitis.