TY - JOUR
T1 - The diagnostic value of staging laparoscopy in gallbladder cancer
T2 - a nationwide cohort study
AU - van Dooren, Mike
AU - de Savornin Lohman, Elise A. J.
AU - Brekelmans, Eva
AU - Vissers, Pauline A. J.
AU - Erdmann, Joris I.
AU - Braat, Andries E.
AU - Hagendoorn, Jeroen
AU - Daams, Freek
AU - van Dam, Ronald M.
AU - de Boer, Marieke T.
AU - van den Boezem, Peter B.
AU - Koerkamp, Bas Groot
AU - de Reuver, Philip R.
N1 - Funding Information: This research was funded by Foundation ADP. The views expressed in the submitted article are of the authors’ own and not an official position of the institution or funder. Publisher Copyright: © 2023, The Author(s).
PY - 2023/12/1
Y1 - 2023/12/1
N2 - Background: Disseminated disease (DD) is often found at (re-)exploration in gallbladder cancer (GBC) patients. We aimed to assess the yield of staging laparoscopy (SL) and identify predictors for DD. Methods: This retrospective study included patients from all Dutch academic centres with primary GBC (pGBC) and incidentally diagnosed GBC (iGBC) planned for (re-)resection. The yield of SL was determined. In iGBC, predictive factors for DD were assessed. Results: In total, 290 patients were included. Of 183 included pGBC patients, 143 underwent laparotomy without SL, and 42 (29%) showed DD perioperatively. SL, conducted in 40 patients, identified DD in eight. DD was found in nine of 32 patients who underwent laparotomy after SL. Of 107 included iGBC patients, 100 underwent laparotomy without SL, and 19 showed DD perioperatively. SL, conducted in seven patients, identified DD in one. Cholecystitis (OR = 4.25; 95% CI 1.51–11.91) and primary R1/R2 resection (OR = 3.94; 95% CI 1.39–11.19) were independent predictive factors for DD. Conclusions: In pGBC patients, SL may identify DD in up to 20% of patients and should be part of standard management. In iGBC patients, SL is indicated after primary resection for cholecystitis and after initial R1/R2 resection due to the association of these factors with DD.
AB - Background: Disseminated disease (DD) is often found at (re-)exploration in gallbladder cancer (GBC) patients. We aimed to assess the yield of staging laparoscopy (SL) and identify predictors for DD. Methods: This retrospective study included patients from all Dutch academic centres with primary GBC (pGBC) and incidentally diagnosed GBC (iGBC) planned for (re-)resection. The yield of SL was determined. In iGBC, predictive factors for DD were assessed. Results: In total, 290 patients were included. Of 183 included pGBC patients, 143 underwent laparotomy without SL, and 42 (29%) showed DD perioperatively. SL, conducted in 40 patients, identified DD in eight. DD was found in nine of 32 patients who underwent laparotomy after SL. Of 107 included iGBC patients, 100 underwent laparotomy without SL, and 19 showed DD perioperatively. SL, conducted in seven patients, identified DD in one. Cholecystitis (OR = 4.25; 95% CI 1.51–11.91) and primary R1/R2 resection (OR = 3.94; 95% CI 1.39–11.19) were independent predictive factors for DD. Conclusions: In pGBC patients, SL may identify DD in up to 20% of patients and should be part of standard management. In iGBC patients, SL is indicated after primary resection for cholecystitis and after initial R1/R2 resection due to the association of these factors with DD.
KW - Gallbladder carcinoma
KW - Gallbladder neoplasms
KW - Staging laparoscopy
UR - http://www.scopus.com/inward/record.url?scp=85146299382&partnerID=8YFLogxK
U2 - https://doi.org/10.1186/s12957-022-02880-z
DO - https://doi.org/10.1186/s12957-022-02880-z
M3 - Article
C2 - 36641472
SN - 1477-7819
VL - 21
JO - World journal of surgical oncology
JF - World journal of surgical oncology
IS - 1
M1 - 6
ER -