Laparoscopic ultrasonography along with staging laparoscopy as a tool for staging in patients with hepatopancreaticobiliary malignancy – A prospective cohort study from a tertiary care centre
Introduction: Staging laparoscopy (SL) plays an important role in avoiding unnecessary non-therapeutic laparotomy in radiologically resectable hepatopancreaticobiliary (HPB) malignancy patients. The limitation of SL is to detect deep-seated malignancy. The addition of laparoscopic ultrasonography fo...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2024-01-01
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| Series: | Journal of Minimal Access Surgery |
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| Online Access: | http://www.journalofmas.com/article.asp?issn=0972-9941;year=2024;volume=20;issue=1;spage=96;epage=101;aulast= |
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| author | Sanjeet Kumar Rai Shakti Swaroop Sarangi Krishna Asuri Om Prakash Prajapati Ankur Goyal Virinder Kumar Bansal |
| author_facet | Sanjeet Kumar Rai Shakti Swaroop Sarangi Krishna Asuri Om Prakash Prajapati Ankur Goyal Virinder Kumar Bansal |
| author_sort | Sanjeet Kumar Rai |
| collection | DOAJ |
| description | Introduction: Staging laparoscopy (SL) plays an important role in avoiding unnecessary non-therapeutic laparotomy in radiologically resectable hepatopancreaticobiliary (HPB) malignancy patients. The limitation of SL is to detect deep-seated malignancy. The addition of laparoscopic ultrasonography for identifying metastatic lesions or locally unresectable disease improves the diagnostic yield of SL.
Patients and Methods: This prospective, observational study was conducted in a single unit of the tertiary care centre between 2017 and 2019. All the patients of HPB malignancy who were radiologically resectable underwent SL and laparoscopic intraoperative ultrasonography. Metastatic disease patients were either underwent palliative bypass procedures or abandoned depending on the condition of the patient. Patients who had resectable disease underwent standard surgical procedures.
Results: Forty patients of HPB malignancy with potentially resectable on radiological imaging underwent SL and diagnostic ultrasonography. Out of 40, 21 patients had periampullary, 14 had carcinoma gallbladder and 5 patients had distal cholangiocarcinoma. Metastatic lesions were identified on laparoscopy in eight patients and the diagnostic yield of SL is 20%. Addition of laparoscopic ultrasonography identified one haemangioma which was false positive on laparoscopy and underwent the radical standard procedure. Four patients were unresectable so the procedure was abandoned and another three patients underwent a bypass procedure.
Conclusion: Laparoscopic ultrasonography during SL can detect deep-seated metastatic lesions and decide the management in resectable disease. |
| first_indexed | 2024-03-07T21:36:04Z |
| format | Article |
| id | doaj.art-e644180ffdc544ed8753b65992da7f76 |
| institution | Directory Open Access Journal |
| issn | 0972-9941 1998-3921 |
| language | English |
| last_indexed | 2024-04-24T13:20:54Z |
| publishDate | 2024-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Minimal Access Surgery |
| spelling | doaj.art-e644180ffdc544ed8753b65992da7f762024-04-04T16:19:15ZengWolters Kluwer Medknow PublicationsJournal of Minimal Access Surgery0972-99411998-39212024-01-012019610110.4103/jmas.jmas_354_22Laparoscopic ultrasonography along with staging laparoscopy as a tool for staging in patients with hepatopancreaticobiliary malignancy – A prospective cohort study from a tertiary care centreSanjeet Kumar RaiShakti Swaroop SarangiKrishna AsuriOm Prakash PrajapatiAnkur GoyalVirinder Kumar BansalIntroduction: Staging laparoscopy (SL) plays an important role in avoiding unnecessary non-therapeutic laparotomy in radiologically resectable hepatopancreaticobiliary (HPB) malignancy patients. The limitation of SL is to detect deep-seated malignancy. The addition of laparoscopic ultrasonography for identifying metastatic lesions or locally unresectable disease improves the diagnostic yield of SL. Patients and Methods: This prospective, observational study was conducted in a single unit of the tertiary care centre between 2017 and 2019. All the patients of HPB malignancy who were radiologically resectable underwent SL and laparoscopic intraoperative ultrasonography. Metastatic disease patients were either underwent palliative bypass procedures or abandoned depending on the condition of the patient. Patients who had resectable disease underwent standard surgical procedures. Results: Forty patients of HPB malignancy with potentially resectable on radiological imaging underwent SL and diagnostic ultrasonography. Out of 40, 21 patients had periampullary, 14 had carcinoma gallbladder and 5 patients had distal cholangiocarcinoma. Metastatic lesions were identified on laparoscopy in eight patients and the diagnostic yield of SL is 20%. Addition of laparoscopic ultrasonography identified one haemangioma which was false positive on laparoscopy and underwent the radical standard procedure. Four patients were unresectable so the procedure was abandoned and another three patients underwent a bypass procedure. Conclusion: Laparoscopic ultrasonography during SL can detect deep-seated metastatic lesions and decide the management in resectable disease.http://www.journalofmas.com/article.asp?issn=0972-9941;year=2024;volume=20;issue=1;spage=96;epage=101;aulast=hepatobiliary malignancylaparoscopic ultrasonographypancreatic malignancystaging laparoscopy |
| spellingShingle | Sanjeet Kumar Rai Shakti Swaroop Sarangi Krishna Asuri Om Prakash Prajapati Ankur Goyal Virinder Kumar Bansal Laparoscopic ultrasonography along with staging laparoscopy as a tool for staging in patients with hepatopancreaticobiliary malignancy – A prospective cohort study from a tertiary care centre Journal of Minimal Access Surgery hepatobiliary malignancy laparoscopic ultrasonography pancreatic malignancy staging laparoscopy |
| title | Laparoscopic ultrasonography along with staging laparoscopy as a tool for staging in patients with hepatopancreaticobiliary malignancy – A prospective cohort study from a tertiary care centre |
| title_full | Laparoscopic ultrasonography along with staging laparoscopy as a tool for staging in patients with hepatopancreaticobiliary malignancy – A prospective cohort study from a tertiary care centre |
| title_fullStr | Laparoscopic ultrasonography along with staging laparoscopy as a tool for staging in patients with hepatopancreaticobiliary malignancy – A prospective cohort study from a tertiary care centre |
| title_full_unstemmed | Laparoscopic ultrasonography along with staging laparoscopy as a tool for staging in patients with hepatopancreaticobiliary malignancy – A prospective cohort study from a tertiary care centre |
| title_short | Laparoscopic ultrasonography along with staging laparoscopy as a tool for staging in patients with hepatopancreaticobiliary malignancy – A prospective cohort study from a tertiary care centre |
| title_sort | laparoscopic ultrasonography along with staging laparoscopy as a tool for staging in patients with hepatopancreaticobiliary malignancy a prospective cohort study from a tertiary care centre |
| topic | hepatobiliary malignancy laparoscopic ultrasonography pancreatic malignancy staging laparoscopy |
| url | http://www.journalofmas.com/article.asp?issn=0972-9941;year=2024;volume=20;issue=1;spage=96;epage=101;aulast= |
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