Diagnostic laparoscopy combined with laparoscopic ultrasonography in staging of cancer of the pancreatic head region

Bemelman, Willem A.; Wit, L. T. de; Delden, Otto M. van; Smits, N. J.; Obertop, H.; Rauws, E.A.J.; Gouma, Dirk J.

doi:10.1002/bjs.1800820633

Cited by 161 publications

(108 citation statements)

References 15 publications

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“…Evaluation of peripancreatic vasculature for tumor invasion and detection of metastatic lymphadenopathy and metastatic liver disease were able to be done by LUS in an attempt to determine whether surgical resection was feasible and appropriate. Similar findings were also reported by Bemelman et al, 43 although with the development of multidetector CT scanning and much higher-speed, higher-quality MRI, preoperative evaluation of pancreatic cancer resectability has become much more accurate.…”

supporting

confidence: 84%

Intraoperative Ultrasonography

Kane

2004

J of Ultrasound Medicine

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AbbreviationsCT, computed tomography; IOUS, intraoperative ultrasonography; LUS, laparoscopic ultrasonography; MRI, magnetic resonance imaging t is a privilege to contribute an article on intraoperative ultrasonography (IOUS) to the series of articles on the history of ultrasound in commemoration of the 50-year anniversary of the American Institute of Ultrasound in Medicine in 2005. On approaching my own 30th anniversary in the practice of diagnostic radiology, it is amazing to reflect back on the uses of A-mode, B-scanning on nonpersistent green fluorescent oscilloscopes, and bistable B-mode scanning as the first primitive diagnostic ultrasonographic tools. Although IOUS began developing in earnest in the late 1970s and early 1980s, after the development of gray scale B-mode ultrasonography and especially after the development of real-time imaging, early investigators were using the more primitive tools as early as the 1960s.One of the very first reports of IOUS was by Schlegel et al 1 in 1961, who used A-mode ultrasonography for the localization of renal calculi ( Figure 1). A-mode was also reported as useful in detection of stones in the gallbladder and common duct in an article by Knight and Newell 2 in 1963 and in another article by Eiseman et al 3 in 1965. A-mode echoencephalography was also reported as useful in delineation of intracerebral mass lesions in a study by Dyck et al 4 in 1966. The inability to display tissue texture in A-mode or bi-stable B-scanning as well as the rather large, bulky size of the equipment limited the more widespread use of IOUS. A small direct-contact ophthalmic B-scanner was developed and proved useful for B-scan ultrasonography during orbital surgery for tumors, as reported by Purnell et al 5 in 1973 (Figure 2), but very little further development was reported until the advent of real-time scanners and smaller, more portable equipment. One of the first reports of real-time B-mode ultrasonographic scanning was by Sigel et al 6 in 1982, which described the use of ultrasonography for precise localization of renal calculi, thereby allowing for the use of smaller nephrotomy incisions, reduced operating room time, and determination that all stone fragments were removed before completion of the procedure. My own experience with IOUS began rather inadvertently in 1983, when I received a call from a distraught surgeon in the operating room, who could not find the intrahepatic abscess that we had shown on preoperative ultrasonography and computed tomography (CT) in a patient

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confidence: 84%

Intraoperative Ultrasonography

Kane

2004

J of Ultrasound Medicine

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“…SL was performed under general anesthesia using three trocars at umbilical and left and right subcostal position, as described previously. 7,8 The hepatic surface and peritoneal cavity were searched for metastases. The hepatoduodenal ligament and gallbladder were inspected for the presence of local tumor mass or enlarged lymph nodes.…”

Section: Staging and Laparoscopymentioning

confidence: 99%

Staging Laparoscopy for Hilar Cholangiocarcinoma: Is it Still Worthwhile?

Ruys

Busch

Gouma

et al. 2012

Indian J Surg Oncol

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Purpose. This study was designed to evaluate the benefit of staging laparoscopy (SL) in patients with suspected hilar cholangiocarcinoma (HCCA) during the past 10 years. Only 50-60% of patients with HCCA who undergo laparotomy are ultimately amenable to a potentially curative resection. In a previous study, we recommended routine use of SL to prevent unnecessary laparotomies. The accuracy of imaging techniques, however, has significantly improved during the past decade, which is likely to impact the yield and accuracy of SL. Methods. From 2000 to 2010, 195 patients with suspected HCCA were analyzed. The yield and accuracy of SL were calculated by dividing total number of avoided laparotomies by the total number of laparoscopies or by all patients with unresectable disease, respectively. Factors associated with better yield and accuracy were assessed. Results. Of 195 patients with HCCA, 175 underwent SL. The yield of SL was 14% and the accuracy was 32%. Operative morbidity of SL was 3%, and operative morbidity of laparotomy for unresectable disease was 33%. No clear factors that influenced the yield of SL were found. Conclusion. Overall yield and accuracy of SL for HCCA in the present series decreased to 14% and 32%, respectively, compared with earlier reports. This finding is likely the result of improved imaging techniques that evolved during the past decade. The place of SL in the workup of patients with HCCA needs to be reconsidered, and one should decide whether the declining additional value of SL still outweighs the drawbacks of SL.

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“…80% of articles extracted were review articles, whilst the remaining did not assess SL/LUS as staging modality. Of the remaining 41 articles, 12 studies did not satisfy the eligibility criteria; 22 were for potentially resectable PPC and 7 for PBC [10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37] (Supplemental information, Table ST1 to attain pneumoperitoneum and were therefore excluded from our analysis. Therefore, a total of 2,827 patients with PPC and 478 patients with PBC, deemed potentially resectable on preoperative staging, were included for analysis.…”

Section: Resultsmentioning

confidence: 99%

“…The mortality and morbidity attributed to the use of laparoscopy in potentially resectable pancreatico-biliary cancers (PPC & PBC) was reported by 9 of the 29 studies included in our analysis [13,14,15,16,17,18,19,20,21]: haemorrhage requiring laparotomy (n=3), port site abscess/infection (n=3), post operative pneumonia (n=2), post procedure pancreatitis (n=2), bile leak (n=2), port site haematoma (n=2), port site recurrence (n=1).…”

Section: Laparoscopy Related Complicationsmentioning

confidence: 99%