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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
Prediction of postoperative survival for hilar cholangiocarcinoma (HCCA) remains difficult although there have been a variety of clinical classification and staging systems. This study was designed to...
The objective of this study was to explore the relationship between PIWI-like protein 2 (PIWIL2) and clinicopathological charac-teristics and prognosis after radical resection. To accomplish this, we ...
Cholangiocarcinoma (CCA) is the second most common primary liver tumour. Intra-hepatic CCA develops within the liver parenchyma while extrahepatic CCA involves the biliary tree within the hepatoduoden...
Liver hilar tuberculous lymphadenitis is extremely rare. A case of liver hilar tuberculous lymphadenitis mimicking lymph node metastasis of anal canal cancer that was successfully diagnosed by laparos...
The purpose of this article is to review imaging workup of perihilar cholangiocarcinoma, including MDCT and MRI protocols, imaging findings, differential diagnosis, and staging. A reporting template i...
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...
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.
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