TY - JOUR
T1 - The Additional Value of Laparoscopic Ultrasound to Staging Laparoscopy in Patients with Suspected Pancreatic Head Cancer
AU - Looijen, Gijs A
AU - Netherlands, University Medical Center Groningen
AU - de Jong, Koert P
AU - Pennings, Jan Pieter
AU - de Meijer, Vincent E
AU - Erdmann, Joris I
N1 - Funding Information:
This study was approved by the Ethics Committee of the University Medical Center Groningen.
Funding Information:
The authors thank Dr. Wouter J. Derksen for his contribution to the manuscript. This abstract was presented on the IHPBA 12th World Congress 2016, Sao Paolo, Brazil. This study was approved by the Ethics Committee of the University Medical Center Groningen. The authors declare that they have no conflict of interest.
Publisher Copyright:
© 2018, The Author(s).
PY - 2018/7
Y1 - 2018/7
N2 - BACKGROUND: This study aimed to evaluate the additional value of laparoscopic ultrasound (LUS) to staging laparoscopy (SL) for detecting occult liver metastases in patients with potentially resectable pancreatic head cancer.METHODS: A retrospective cohort study was performed including all patients who underwent SL and LUS between 2005 and 2016. LUS was performed during SL to detect liver metastases not found by preoperative imaging or visual inspection of the liver.RESULTS: Out of 197 patients, visual inspection during SL detected distant metastases in 29 (14.7%) patients. LUS was performed in 127 patients, revealing 3 additional liver metastases. The proportion of patients with unresectable disease after SL and negative LUS was 32.3%, which was similar to 36.6% of patients with unresectable disease after SL without LUS (difference 4.3%; 95% CI - 13-23%; P = 0.61). Sensitivity, specificity, and positive and negative predictive values of LUS to detect liver metastases were 30, 100, 100, and 94%, respectively. The proportion of patients with distant metastases diagnosed at SL significantly increased over time (P = 0.031).CONCLUSION: The routine use of LUS during SL for patients with potentially resectable pancreatic head cancer cannot be recommended. Imaging should be repeated when significant delay occurs between index CT and the scheduled surgery.
AB - BACKGROUND: This study aimed to evaluate the additional value of laparoscopic ultrasound (LUS) to staging laparoscopy (SL) for detecting occult liver metastases in patients with potentially resectable pancreatic head cancer.METHODS: A retrospective cohort study was performed including all patients who underwent SL and LUS between 2005 and 2016. LUS was performed during SL to detect liver metastases not found by preoperative imaging or visual inspection of the liver.RESULTS: Out of 197 patients, visual inspection during SL detected distant metastases in 29 (14.7%) patients. LUS was performed in 127 patients, revealing 3 additional liver metastases. The proportion of patients with unresectable disease after SL and negative LUS was 32.3%, which was similar to 36.6% of patients with unresectable disease after SL without LUS (difference 4.3%; 95% CI - 13-23%; P = 0.61). Sensitivity, specificity, and positive and negative predictive values of LUS to detect liver metastases were 30, 100, 100, and 94%, respectively. The proportion of patients with distant metastases diagnosed at SL significantly increased over time (P = 0.031).CONCLUSION: The routine use of LUS during SL for patients with potentially resectable pancreatic head cancer cannot be recommended. Imaging should be repeated when significant delay occurs between index CT and the scheduled surgery.
KW - Aged
KW - Endosonography/methods
KW - Female
KW - Humans
KW - Laparoscopy/methods
KW - Male
KW - Middle Aged
KW - Neoplasm Staging/methods
KW - Pancreas/diagnostic imaging
KW - Pancreatic Neoplasms/diagnosis
KW - Retrospective Studies
KW - Staging laparoscopy
KW - Laparoscopic ultrasound
KW - Pancreatic cancer
KW - Pancreas
KW - Pancreatic surgery
UR - http://www.scopus.com/inward/record.url?scp=85043464690&partnerID=8YFLogxK
U2 - 10.1007/s11605-018-3726-9
DO - 10.1007/s11605-018-3726-9
M3 - Article
C2 - 29532360
SN - 1091-255X
VL - 22
SP - 1186
EP - 1192
JO - Journal of Gastrointestinal Surgery
JF - Journal of Gastrointestinal Surgery
IS - 7
ER -