Chirurgische laparoskopie - Staging gastrointestinaler tumoren mit der erweiterten diagnostischen laparoskopie

The so-called extended diagnostic laparoscopy (EDL) allows the comprehensive exploration of the whole abdominal cavity. This strategy of minimal-invasive tumor staging improves the precision of the pretherapeutic work-up in gastrointestinal malignancies. EDL consists of the visual exploration including dissection of all relevant primarily inaccessible anatomic sites. Laparoscopic ultrasound and the retrieval of relevant tissue samples obtained by biopsy and cytology are included. Relevant therapeutic information was achieved by EDL in 40.5% of gastric cancer patients. The EDL could be of similar importance for diagnosing secondaries of adenocarcinomas of the distal esophagus and of hepatobiliary and pancreatic malignancies. The overall complication rate of EDL is low. Nevertheless, EDL should only be performed in cases in whom therapeutic consequences are probable.