World Journal of Surgical Oncology (Jan 2023)

The diagnostic value of staging laparoscopy in gallbladder cancer: a nationwide cohort study

  • Mike van Dooren,
  • Elise A. J. de Savornin Lohman,
  • Eva Brekelmans,
  • Pauline A. J. Vissers,
  • Joris I. Erdmann,
  • Andries E. Braat,
  • Jeroen Hagendoorn,
  • Freek Daams,
  • Ronald M. van Dam,
  • Marieke T. de Boer,
  • Peter B. van den Boezem,
  • Bas Groot Koerkamp,
  • Philip R. de Reuver

DOI
https://doi.org/10.1186/s12957-022-02880-z
Journal volume & issue
Vol. 21, no. 1
pp. 1 – 8

Abstract

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Abstract 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.

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