The greater part of patients presenting with pancreatic cancer is irresectable at the time of diagnosis. They are in need of palliative treatment. We report our first experience with a new concept of laparoscopic palliation based on the findings of preoperative imaging and diagnostic laparoscopy. Between 1995 and 1998, 10 patients underwent laparoscopic palliation. In 3 cases laparoscopic double bypass and 7 patients gastroenterostomy was performed, in some instances combined with endoscopic stenting. Postoperative morbidity was 10% for laparoscopic palliation. There was no mortality in laparoscopic bypass surgery. Postoperative hospital stay averaged 11 days. Our preliminary experience strongly suggests that laparoscopic palliation may greatly reduce the three major drawbacks of open bypass surgery, i.e. high morbidity and mortality, and long postoperative hospital stay. Prospective trials in larger study populations will be needed to define the place of this technique in the palliation of pancreatic cancer.
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