Laparoscopy in the diagnosis of primary carcinoma of the gallbladder

Dagnini, G; Marin, Geobel A.; Patella, Miriam; Zotti, S

doi:10.1016/s0016-5107(84)72420-5

Cited by 26 publications

(4 citation statements)

References 3 publications

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“…The results of the present study show that the incidence of DD in patients undergoing re‐exploration for IGBC was relatively low at 14.0%, and that the yield and accuracy of laparoscopic re‐staging were equally low. Indeed, the results were inferior to those reported for SL in previous publications, although it must be emphasized that these studies included patients at greater risk for DD, specifically comprising patients with primary GBC and patients with symptoms caused by GBC 9,11,14,15,28 . Thus, clinical presentation would appear to be a useful criterion in the selection of GBC patients for SL, but its utility in patients with IGBC is likely to be very low because symptoms are often absent in this subgroup.…”

Section: Discussionmentioning

confidence: 74%

“…Thus, the rationale and potential benefits of SL must be weighed against the added cost and increased operating time incurred by using it in patients who are at low risk for DD. The role of SL in patients with IGBC has not been clearly defined because most studies have included patients with primary gallbladder tumours, which appear to have a higher risk for metastatic disease, or those with findings suspicious for GBC on preoperative imaging 14,15 . The heterogeneity of patients included in these studies brings into question the objective evaluation of patients with IGBC and prevents the drawing of definitive conclusions.…”

Section: Introductionmentioning

confidence: 99%

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The role of laparoscopic staging in patients with incidental gallbladder cancer

Butte

Gönen

Allen

et al. 2011

HPB

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Section: Discussionmentioning

confidence: 74%

Section: Introductionmentioning

confidence: 99%

The role of laparoscopic staging in patients with incidental gallbladder cancer

Butte

Gönen

Allen

et al. 2011

HPB

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“…In their series of 23 patients, disseminated disease was found at laparoscopy in 39% of the patients. Dagnini et al [15] reported on the use of laparoscopy for the diagnosis of GBC in 98 patients. In another study, Kriplani et al [16] evaluated the role of laparoscopy in the diagnosis and preoperative staging of gallbladder carcinoma.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Staging in Gallbladder Cancer

Agrawal¹,

Sonawane²,

Behari³

et al. 2005

Dig Surg

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Purpose: Laparoscopy is beneficial in the staging of pancreatic and upper gastrointestinal malignancies but its role in gallbladder cancer has not been investigated. We evaluated the role of laparoscopy in the staging of gallbladder cancer. Methods: From 1989 through 2001, 91 patients with gallbladder cancer, without any evidence of metastatic disease on imaging (ultrasound and/or computed tomographic scan), underwent staging laparoscopy. Peritoneal and surface liver metastases were looked for and assessment of local spread was done if possible. Assessment was based on visual impression and biopsies were not obtained routinely. Results: At laparoscopy, 34 (37%) patients had disseminated disease in the form of liver and/or peritoneal deposits; no further surgery was performed in 29 of these patients while 5 patients underwent surgical bypass procedures. Liver metastases were missed at laparoscopy in 2 patients and were subsequently found at laparotomy. Assessment of the gallbladder mass was possible in 33 (36%) patients, 6 of these were found to have extensive local disease and did not undergo any further surgery. Laparoscopic staging, thus avoided further surgery in 35 (38%) patients. Of the 51 patients without metastatic disease, who underwent laparotomy, 11 were found to have nonresectable locally advanced disease while 1 had liver metastases, which were missed at laparoscopy; 7 underwent bypass procedures only; 21 underwent simple cholecystectomy and extended cholecystectomy was done in 11 patients. The resectability rate (number of resections/operations) in patients undergoing laparoscopic staging was 57% (32/56) as compared with 43% (142/328) in those who did not undergo laparoscopy. Conclusions: Staging laparoscopy in patients with gallbladder cancer detected liver and peritoneal metastases that were missed on imaging. It reduced the number of unnecessary surgical explorations and improved the resectability rate.

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“…We believe that the role of the laparoscopic approach in detecting unresectable disease depends on the category of biliary tract malignancy. Previous studies [17,18] of laparoscopy staging in GBC found a much higher rate of operation termination due to the metastatic disease. This difference may be due to a lack of precise preoperative imaging detection.…”

Section: Discussionmentioning

confidence: 92%

Diagnostic and Prognostic Role of Laparoscopic Staging for Gallbladder Carcinoma

et al. 2012

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Background: The aim of this study was to evaluate the diagnostic and prognostic role of staging laparoscopy in gallbladder carcinoma (GBC). Methods: From January 2007 through December 2010, 79 GBC patients without evidence of metastatic disease on preoperative imaging underwent staging laparoscopy. Peritoneal and liver metastases were assessed by a single surgeon in a systematic manner. Resection rate, safety, and survival analysis were compared between the laparoscopy group and no laparoscopy group. Results: Disseminated disease was detected in 27 patients and no further surgery was performed; the overall accuracy for detecting unresectable disease was 67.5% (27/40), with 39 (75%) and 27 (51.9%) receiving resection and curative resection. In 203 GBC patients undergoing laparotomy, 90 (44.3%) and 53 (26.1%) patients received resection and curative resection; therefore, the resection rate and curative resection rate were significantly much higher in the laparoscopy group (p < 0.000). Conclusions: Staging laparoscopy in GBC is sensitive in detecting disseminated disease and increases the curative resection rate, shortens the recovery time, and has no negative implications on overall survival; therefore, we suggest the routine use of staging laparoscopy in patients with GBC without evidence of disseminated disease on preoperative imaging.

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Laparoscopy in the diagnosis of primary carcinoma of the gallbladder

Cited by 26 publications

References 3 publications

The role of laparoscopic staging in patients with incidental gallbladder cancer

The role of laparoscopic staging in patients with incidental gallbladder cancer

Laparoscopic Staging in Gallbladder Cancer

Diagnostic and Prognostic Role of Laparoscopic Staging for Gallbladder Carcinoma

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