Laparoscopic staging of biliopancreatic malignancy.

The main benefit of laparoscopic staging (LLU) of (distal) bilio-pancreatic malignancy is the detection of small superficial metastases at the liver surface and peritoneum and local tumor ingrowth. The different aspects of laparoscopic staging have been described extensively in the literature and the benefit is generally expressed in terms of prevention of laparotomy. The impact of this final staging procedure on outcome for the patient in terms of the efficacy of the subsequent non-surgical palliative treatment have been analysed scarsely. In this review the results of laparoscopic staging of bilio-pancreatic tumors concerning the detection of metastases and tumor ingrowth as well as the results of long term follow up after subsequent non-surgical treatment and the preferred palliative treatment after laparoscopic staging are discussed.