Pancreatic adenocarcinoma (PAC) has poor survival outcomes, with surgical resection offering the only potential for cure. Diagnostic laparoscopy (DL) may detect occult metastatic disease and prevent unnecessary laparotomy, but its population-level impact is unclear. This population-based retrospective cohort study used Oregon State Cancer Registry data (1996–2003) to examine whether DL improved resection with curative intent (RCI) among patients with potentially resectable PAC. DL altered management in 27.9% of cases but was associated with lower odds of RCI, particularly in low-volume hospitals. Findings suggest DL is used selectively and does not improve resectability, highlighting the importance of hospital volume and referral patterns in PAC management.
