Impact of the type of venous reconstruction and venous tumour infiltration in portal vein resection for borderline resectable pancreatic cancer

Abstract

providing data on the diagnostic accuracy of SL in PHC. Primary outcomes were overall yield and sensitivity to detect unresectable disease. Secondary outcomes were the yield and sensitivity for recent studies (after 2010), large study cohorts (100 patients) and specific lesions. Methodological quality of studies was assessed with the QUADAS-2 tool. Results: From 173 records, 12 studies including 832 patients met the inclusion criteria. The yield of SL in PHC varied from 6.4e45.0% with a pooled yield of 24.4% (95% Confidence Interval [CI]: 16.4e33.4). Sensitivity to detect unresectable disease ranged from 31.6e75% with a pooled sensitivity of 52.2% (95%CI: 47.1%e57.2%). Sensitivity was highest for peritoneal metastases (80.7%, 95%CI: 70.9e88.3). Subgroup analysis revealed that the yield and sensitivity tended to be lower for studies after 2010. Considerable heterogeneity was detected among the studies. Conclusions: There is a lack of evidence supporting the routine use of staging laparoscopy in PHC. Studies that identify predictors of unresectability are needed in order to select patients who will benefit the most from this procedure.