Laparoscopic palliation of unresectable pancreatic cancers: preliminary results.

OBJECTIVE - To assess the feasibility of laparoscopic gastroenteric and cholecystenteric bypass procedures for palliation of inoperable cancer of the pancreas. DESIGN - Prospective study. SETTING - Teaching hospital, Italy. SUBJECTS - 6 patients (4 men and 2 women, range 53-72 years, median 64) who presented between July 1995 and April 1997 with inoperable pancreatic cancer. INTERVENTIONS - Laparoscopic gastroenterostomy for duodenal obstruction. Four patients had already had endoscopic biliary decompression. 2 patients also had laparoscopic cholecystojejunostomy for biliary obstruction at the time of the laparoscopic gastroenterostomy. MAIN OUTCOME MEASURES - Morbidity and mortality. RESULTS - The procedure was completed laparoscopically in all patients. There was no perioperative mortality and morbidity was low (1 bleeding from the drain and 1 paralytic ileus). The median postoperative stay was 4.5 days (range 4-6). CONCLUSIONS - Laparoscopic gastroenterostomy, together with cholecystojejunostomy in selected patients with inoperable pancreatic cancer, offers a less invasive alternative to open surgery with a short hospital stay and rapid return to normal activity.