Journal of Gastrointestinal Surgery

, Volume 12, Issue 7, pp 1177–1184 | Cite as

Diagnostic Laparoscopy for Patients with Potentially Resectable Pancreatic Adenocarcinoma: Is It Cost-Effective in the Current Era?

  • C. K. Enestvedt
  • S. C. Mayo
  • B. S. Diggs
  • M. Mori
  • D. A. Austin
  • D. K. Shipley
  • B. C. Sheppard
  • K. G. BillingsleyEmail author
ahpba annual meeting



For patients with potentially resectable pancreatic cancer, diagnostic laparoscopy may identify liver and peritoneal metastases that are difficult to detect with other staging modalities. The aim of this study was to utilize a population-based pancreatic cancer database to assess the cost effectiveness of preoperative laparoscopy.

Material and Methods

Data from a state cancer registry were linked with primary medical record data for years 1996–2003. De-identified patient records were reviewed to determine the role and findings of laparoscopic exploration. Average hospital and physician charges for laparotomy, biliary bypass, pancreaticoduodenectomy, and laparoscopy were determined by review of billing data from our institution and Medicare data for fiscal years 2005–2006. Cost-effectiveness was determined by comparing three methods of utilization of laparoscopy: (1) routine (all patients), (2) case-specific, and (3) no utilization.

Results and Discussion

Of 298 potentially resectable patients, 86 underwent laparoscopy. The prevalence of unresectable disease was 14.1% diagnosed at either laparotomy or laparoscopy. The mean charge per patient for routine, case-specific, and no utilization of laparoscopy was $91,805, $90,888, and $93,134, respectively.


Cost analysis indicates that the case-specific or routine use of laparoscopy in pancreatic cancer does not add significantly to the overall expense of treatment and supports the use of laparoscopy in patients with known or suspected pancreatic adenocarcinoma.


Pancreatic cancer Laparoscopy Diagnostic laparoscopy Cost-effective 



The authors wish to thank Dr. Charles Vollmer for his generous assistance in the preparation of this manuscript.


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Copyright information

© The Society for Surgery of the Alimentary Tract 2008

Authors and Affiliations

  • C. K. Enestvedt
    • 1
  • S. C. Mayo
    • 2
  • B. S. Diggs
    • 1
  • M. Mori
    • 3
    • 4
  • D. A. Austin
    • 4
  • D. K. Shipley
    • 5
  • B. C. Sheppard
    • 1
  • K. G. Billingsley
    • 1
    • 6
    Email author
  1. 1.Department of SurgeryOregon Health & Science UniversityPortlandUSA
  2. 2.Department of SurgeryJohns Hopkins HospitalBaltimoreUSA
  3. 3.Department of BiostatisticsOregon Health & Science UniversityPortlandUSA
  4. 4.Department of Public Health and Preventive MedicineOregon Health & Science UniversityPortlandUSA
  5. 5.Oregon State Cancer RegistryPortlandUSA
  6. 6.Division of Surgical OncologyOregon Health & Science UniversityPortlandUSA

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