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The role of laparoscopic staging in patients with incidental gallbladder cancer

Publication ,  Journal Article
Butte, JM; Gönen, M; Allen, PJ; D'Angelica, MI; Kingham, TP; Fong, Y; Dematteo, RP; Blumgart, L; Jarnagin, WR
Published in: HPB
January 1, 2011

Background: The role of staging laparoscopy (SL) in patients with incidental gallbladder cancer (IGBC) is ill defined. This study evaluates the utility of SL with the aim of identifying variables associated with disseminated disease (DD). Methods: Consecutive patients with IGBC who underwent re-exploration between 1998 and 2009 were identified from a prospective database. The yield and accuracy of SL were calculated. Demographics, tumour- and treatment-related variables were correlated with findings of DD. Results: Of the 136 patients submitted to re-exploration for possible definitive resection, 19 (14.0%) had DD. Staging laparoscopy was carried out in 46 (33.8%) patients, of whom 10 (21.8%) had DD (peritoneal disease [n= 6], liver metastases [n= 3], retroperitoneal disease [n= 1]). Disseminated disease was identified by SL in two patients (yield = 4.3%), whereas eight were diagnosed after conversion to laparotomy (accuracy = 20.0%). The likelihood of DD correlated closely with T-stage (T1b, n= 0; T2, n= 5 [7.0%], T3, n= 14 [26.0%]; P= 0.004). A positive margin at initial cholecystectomy (odds ratio [OR] 5.44, 95% confidence interval [CI] 1.51-24.37; P= 0.004) and tumour differentiation (OR 7.64, 95% CI 1.1-NA; P= 0.006) were independent predictors of DD on multivariate analysis. Discussion: Disseminated disease is relatively uncommon in patients with IGBC and SL provides a very low yield. However, patients with poorly differentiated, T3 or positive-margin gallbladder tumours are at high risk for DD and targeting these patients may increase the yield of SL. © 2011 International Hepato-Pancreato-Biliary Association.

Duke Scholars

Published In

HPB

DOI

EISSN

1477-2574

ISSN

1365-182X

Publication Date

January 1, 2011

Volume

13

Issue

7

Start / End Page

463 / 472

Related Subject Headings

  • Surgery
  • 3202 Clinical sciences
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
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Butte, J. M., Gönen, M., Allen, P. J., D’Angelica, M. I., Kingham, T. P., Fong, Y., … Jarnagin, W. R. (2011). The role of laparoscopic staging in patients with incidental gallbladder cancer. HPB, 13(7), 463–472. https://doi.org/10.1111/j.1477-2574.2011.00325.x
Butte, J. M., M. Gönen, P. J. Allen, M. I. D’Angelica, T. P. Kingham, Y. Fong, R. P. Dematteo, L. Blumgart, and W. R. Jarnagin. “The role of laparoscopic staging in patients with incidental gallbladder cancer.” HPB 13, no. 7 (January 1, 2011): 463–72. https://doi.org/10.1111/j.1477-2574.2011.00325.x.
Butte JM, Gönen M, Allen PJ, D’Angelica MI, Kingham TP, Fong Y, et al. The role of laparoscopic staging in patients with incidental gallbladder cancer. HPB. 2011 Jan 1;13(7):463–72.
Butte, J. M., et al. “The role of laparoscopic staging in patients with incidental gallbladder cancer.” HPB, vol. 13, no. 7, Jan. 2011, pp. 463–72. Scopus, doi:10.1111/j.1477-2574.2011.00325.x.
Butte JM, Gönen M, Allen PJ, D’Angelica MI, Kingham TP, Fong Y, Dematteo RP, Blumgart L, Jarnagin WR. The role of laparoscopic staging in patients with incidental gallbladder cancer. HPB. 2011 Jan 1;13(7):463–472.
Journal cover image

Published In

HPB

DOI

EISSN

1477-2574

ISSN

1365-182X

Publication Date

January 1, 2011

Volume

13

Issue

7

Start / End Page

463 / 472

Related Subject Headings

  • Surgery
  • 3202 Clinical sciences
  • 1103 Clinical Sciences