Gijs A Looijen1, Bobby K Pranger2, Koert P de Jong1, Jan Pieter Pennings3, Vincent E de Meijer1, Joris I Erdmann1. 1. Division of Hepatopancreatobiliary Surgery and Liver Transplantation, University of Groningen and University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands. 2. Division of Hepatopancreatobiliary Surgery and Liver Transplantation, University of Groningen and University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands. b.k.pranger@umcg.nl. 3. Department of Radiology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands.
Abstract
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.
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.
Authors: Mark P Callery; Kenneth J Chang; Elliot K Fishman; Mark S Talamonti; L William Traverso; David C Linehan Journal: Ann Surg Oncol Date: 2009-04-24 Impact factor: 5.344
Authors: N Alexakis; I P Gomatos; S Sbarounis; K Toutouzas; S Katsaragakis; G Zografos; M M Konstandoulakis Journal: Eur J Surg Oncol Date: 2014-09-18 Impact factor: 4.424
Authors: Eliza E Long; Jacques Van Dam; Stefanie Weinstein; Brooke Jeffrey; Terry Desser; Jeffrey A Norton Journal: Surg Oncol Date: 2005-08 Impact factor: 3.279
Authors: Keith J Roberts; Pooja Prasad; Yvonne Steele; Francesca Marcon; Thomas Faulkner; Hentie Cilliers; Bobby Dasari; Manuel Abradelo; Ravi Marudanayagam; Robert P Sutcliffe; Paolo Muiesan; Darius F Mirza; John Isaac Journal: HPB (Oxford) Date: 2017-05-26 Impact factor: 3.647
Authors: S Sanjeevi; T Ivanics; L Lundell; N Kartalis; Å Andrén-Sandberg; J Blomberg; M Del Chiaro; C Ansorge Journal: Br J Surg Date: 2015-11-17 Impact factor: 6.939
Authors: C Mattevi; J Garnier; U Marchese; J Ewald; M Gilabert; F Poizat; G Piana; J R Delpero; O Turrini Journal: BMC Surg Date: 2020-08-05 Impact factor: 2.102
Authors: Daniel R Principe; Patrick W Underwood; Murray Korc; Jose G Trevino; Hidayatullah G Munshi; Ajay Rana Journal: Front Oncol Date: 2021-07-15 Impact factor: 6.244