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Journal of Gastrointestinal Surgery
Published in: Journal of Gastrointestinal Surgery 7/2018

Open Access 01-07-2018 | Original Article

The Additional Value of Laparoscopic Ultrasound to Staging Laparoscopy in Patients with Suspected Pancreatic Head Cancer

Authors: Gijs A. Looijen, Bobby K. Pranger, Koert P. de Jong, Jan Pieter Pennings, Vincent E. de Meijer, Joris I. Erdmann

Published in: Journal of Gastrointestinal Surgery | Issue 7/2018

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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.
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Metadata
Title
The Additional Value of Laparoscopic Ultrasound to Staging Laparoscopy in Patients with Suspected Pancreatic Head Cancer
Authors
Gijs A. Looijen
Bobby K. Pranger
Koert P. de Jong
Jan Pieter Pennings
Vincent E. de Meijer
Joris I. Erdmann
Publication date
01-07-2018
Publisher
Springer US
Published in
Journal of Gastrointestinal Surgery / Issue 7/2018
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-018-3726-9

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