Diagnostic laparoscopy combined with laparoscopic ultrasonography in staging of cancer of the pancreatic head region
Diagnostic laparoscopy combined with laparoscopic ultrasonography in staging of cancer of the pancreatic head region
复制标题
诊断性腹腔镜联合腹腔镜超声检查在胰头癌分期中的应用
DOI：
10.1002/bjs.1800821248
复制
发表时间：
1995
影响因子：
9.6
通讯作者：
D. Gouma
中科院分区：
文献类型：
--
作者：
A. Carmichael;B. Jackson;W. Bemelman;D. Gouma
本研究的目的是评估诊断性腹腔镜检查联合腹腔镜超声检查在胰头恶性肿瘤患者分期中的额外作用。 1993年1月至1994年6月期间，经术前检查（内镜逆行胰胆管造影和多普勒超声检查）确定73例患有I期胰头癌的患者符合腹腔镜超声检查的条件。检查腹腔是否有腹膜沉积物、肝内转移、门静脉和肠系膜上血管恶性浸润以及 N3 淋巴结转移。所有没有组织学证实转移的患者均进行剖腹手术。七十名患者有资格进行评估。 21 例远处转移患者中，16 例通过腹腔镜超声检查确诊。 49 名患者进行了手术探查和试验解剖以评估局部可切除性。 29 名患者（41%）患有可切除的胰头肿瘤。腹腔镜超声检查确定的局部向内生长的阳性预测值为 93%。 19% 的患者避免了剖腹手术，41% 的患者改变了术前分期。腹腔镜检查（包括超声检查）可有效对胰头恶性肿瘤进行分期。
The aim of this study was to assess the additional role of diagnostic laparoscopy combined with laparoscopic ultrasonography in the staging of patients with pancreatic head malignancy. Between January 1993 and June 1994, 73 patients with stage I cancer of the pancreatic head determined by preoperative investigation (endoscopic retrograde cholangiopancreatography and Doppler ultrasonography) were eligible for laparoscopic ultrasonography. The peritoneal cavity was investigated for peritoneal deposits, intrahepatic metastases, malignant infiltration of the portal and superior mesenteric vessels, and N3 lymph node metastases. All patients without histologically proven metastases proceeded to laparotomy. Seventy patients were eligible for evaluation. Sixteen of the 21 patients with distant metastases were diagnosed by laparoscopy with ultrasonography. Forty-nine patients had surgical exploration and trial dissection to assess local resectability. Twenty-nine patients (41 per cent) had resectable pancreatic head tumours. The positive predictive value of local ingrowth as determined by laparoscopic sonography was 93 per cent. Laparotomy was avoided in 19 per cent of patients and the preoperative stage was changed in 41 per cent. Laparoscopy including ultrasonography was effective in staging pancreatic head malignancy.