• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Surgical Endoscopy >Utility of staging laparoscopy in subsets of biliary cancers : laparoscopy is a powerful diagnostic tool in patients with intrahepatic and gallbladder carcinoma.
【24h】

Utility of staging laparoscopy in subsets of biliary cancers : laparoscopy is a powerful diagnostic tool in patients with intrahepatic and gallbladder carcinoma.

机译：腹腔镜分期在胆道癌子集中的实用性：腹腔镜检查是肝内和胆囊癌患者的有力诊断工具。

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

BACKGROUND: The aim of this study was to evaluate the utility of staging laparoscopy in patients with biliary cancers in the era of modern diagnostic imaging. METHODS: From September 2002 through August 2004, 39 consecutive patients with potentially resectable cholangiocarcinoma underwent preoperative staging laparoscopy before laparotomy. Preoperative imaging included ultrasonography and triphasic computed tomography for all patients and magnetic resonance cholangiography in 35 patients (90%). Final pathological diagnosis included 20 hilar cholangiocarcinomas (HC), 11 intrahepatic cholangiocarcinomas (IHC), and eight gallbladder carcinomas (GBC). RESULTS: During laparoscopy, unresectable disease was found in 14/39 patients (36%). The main causes of unresectability were peritoneal carcinomatosis (11/14) and liver metastases (5/14). At laparotomy, nine patients (37%) were found to have advanced disease precluding resection. Vascular invasion and nodal metastases were the main causes of unresectability during laparotomy (eight out of nine). In detecting peritoneal metastases and liver metastases, laparoscopy had an accuracy of 92 and 71%, respectively. All patients with vascular or nodal involvement were missed by laparoscopy. For prediction of unresectability disease, the yield and accuracy of laparoscopy were highest for GBC (62% yield and 83% accuracy), followed by IHC (36% yield and 67% accuracy) and HC (25% yield and 45% accuracy) CONCLUSION: Staging laparoscopy ensured that unnecessary laparotomy was not performed in 36% of patients with potentially resectable biliary carcinoma after extensive preoperative imaging. In patients with biliary carcinoma that appears resectable, staging laparoscopy allows detection of peritoneal and liver metastasis in one third of patients. Both vascular and lymph nodes invasions were not diagnosed by this procedure. Due to these limitations, laparoscopy is more useful in ruling out dissemination in GBC and IHC than in HC.
机译：背景：本研究的目的是评估在现代诊断成像时代腹腔镜分期在胆道癌患者中的实用性。方法：从2002年9月至2004年8月，连续39例潜在可切除的胆管癌患者在进行剖腹手术之前接受了腹腔镜手术。术前影像检查包括所有患者的超声检查和三相计算机断层扫描以及35例患者（90％）的磁共振胆道造影。最终的病理诊断包括20例肝门胆管癌（HC），11例肝内胆管癌（IHC）和8例胆囊癌（GBC）。结果：在腹腔镜检查中，有14/39例患者（36％）发现了无法切除的疾病。不可切除的主要原因是腹膜癌变（11/14）和肝转移（5/14）。在剖腹手术中，发现9例患者（37％）患有晚期疾病且无法切除。血管侵入和淋巴结转移是剖腹手术中无法切除的主要原因（九分之八）。在检测腹膜转移和肝转移时，腹腔镜检查的准确率分别为92％和71％。腹腔镜检查漏诊了所有有血管或淋巴结受累的患者。对于不可切除疾病的预测，GBC的腹腔镜检查的产率和准确性最高（62％的产率和83％的准确性），其次是IHC（36％的产率和67％的准确性）和HC（25％的产率和45％的准确性）。 ：分期腹腔镜检查可确保在术前广泛影像学检查后，有36％可能切除的胆道癌患者无需进行不必要的剖腹手术。对于看似可切除的胆道癌患者，分期腹腔镜检查可以检测三分之一患者的腹膜和肝转移。此程序未诊断出血管和淋巴结浸润。由于这些限制，腹腔镜检查在排除GBC和IHC中的传播方面比在HC中更有用。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号