Laparoscopic staging in hilar cholangiocarcinoma: Is it still justified?
Summary of "Laparoscopic staging in hilar cholangiocarcinoma: Is it still justified?"
Radical resection remains the only potential curative therapy for hilar cholangiocarcinoma (HCCA). The aim of staging laparoscopic (SL) is to identify patients with previously undetected advanced disease who will not benefit from surgical palliation and therefore avoid unnecessary laparotomies. The accuracy of non-invasive imaging techniques has significantly improved during the last years. As a consequence, the diagnostic yield of SL of biliary tract malignancy should have decreased proportionally. At the same time, some authors have recently questioned the value of laparoscopic ultrasound (LUS) as a complement of SL. In this setting, the precise role of SL and LUS in the preoperative workup of HCCA remains unclear. As it seems undoubtedly clear that its efficacy has decreased in the last decades, there is a general consensus that the universal use of SL shouldn't be recommended anymore; SL should be performed only in selected patients with higher risk of holding unresectable disease (T2/T3 or Bismuth type 3/4 and patients with suspicion of metastases). It would also be recommended in patients with potentially resectable disease who would need preoperative invasive procedures. Finally, SL should be performed preceding laparotomy in one session. Further studies on the benefit of SL and LUS in this subset of HCCA patients are warranted.
Fernando Rotellar, Fernando Pardo, HPB and Liver Transplant Unit, Department of General and Abdominal Surgery, University Clinic of Navarre, University of Navarre, 31008 Pamplona, Spain.
This article was published in the following journal.
Name: World journal of gastrointestinal oncology
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/23919106
- DOI: http://dx.doi.org/10.4251/wjgo.v5.i7.127
We have done curative or palliative extended extrahepatic bile duct resection at the level of the hilar plate for selected patients with cholangiocarcinoma with hilar spreading, calling this procedure...
Cholangiocarcinoma (CCA) is the second most common malignant tumor of the liver. It is simply classified as intrahepatic and extrahepatic CCA (including perihilar and distal extra hepatic CCA) accordi...
Multiplanar reconstruction (MPR) images are used for assessing horizontal and vertical extent of hilar cholangiocarcinoma, while peroral cholangioscopy (POCS) is used for diagnosing ductal spread and ...
Routine experiences suggest that cholangiocarcinomas (CCAs) show different clinicopathological behaviors along the biliary tree, and hilar CCA apparently resembles pancreatic duct adenocarcinoma (PDAC...
In this study, we evaluated the safety and efficacy of using the LigaSure sealing system (Valleylab, Boulder, Colorado) for laparoscopic decortication of symptomatic hilar renal cysts.
To evaluate the feasibility and performance of coregistered 18F-FDG-PET/MRI in the staging of potentially respectable hilar cholangiocarcinoma.
The investigators conducted a prospective study to determine the safety and efficacy of minor and major hepatectomy selected by predetermined criteria in 138 patients with hilar cholangioc...
This study is to investigate whether preoperative biliary drainage can reduce the postoperative morbidity in patients with hilar cholangiocarcinoma.
The purpose of this study is to compare the quality of life in patients with unresectable hilar cholangiocarcinoma on palliative metallic stent versus plastic Stent.
RATIONALE: Laparoscopic staging may help doctors plan more effective treatment for ovarian, primary fallopian tube, and primary abdominal cancers. PURPOSE: Phase II trial to study the eff...
Medical and Biotech [MESH] Definitions
A malignant tumor arising from the intrahepatic bile duct epithelium. It is composed of ducts lined by cuboidal or columnar cells that do not contain bile, with abundant stroma. (From Holland et al., Cancer Medicine, 3d ed, p1455; Stedman, 25th ed)
Excision of the gallbladder through an abdominal incision using a laparoscope.
A drug that has analgesic, anti-inflammatory, and antipyretic properties. It is the sodium sulfonate of AMINOPYRINE. Because of the risk of serious adverse effects its use is justified only in serious situations where no alternative is available or suitable. (From Martindale, The Extra Pharmacopoeia, 30th ed, p13)
Serological tumor marker composed of a molecular complex of cytokeratins 8, 18, and 19. It is used in the diagnosis and staging of bronchogenic carcinoma.
Methods which attempt to express in replicable terms the extent of the neoplasm in the patient.