Skip to main content

Advertisement

Log in

The role of staging laparoscopy for intraabdominal cancers: an evidence-based review

  • Review
  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Diagnostic laparoscopy is minimally invasive surgery for the diagnosis of intraabdominal diseases. The aim of this review is a critical examination of the available literature on the role of laparoscopy for the staging of intraabdominal cancers. A systematic literature search of English-language articles on MEDLINE, the Cochrane database of evidence-based reviews, and the Database of Abstracts of Reviews of Effects was performed for the period 1995–2006. The level of evidence in the identified articles was graded. The search identified and reviewed seven main categories that have received attention in the literature: esophageal cancer, gastric cancer, pancreatic cancer, hepatocellular carcinoma, biliary tract cancer, colorectal cancer, and lymphoma. The indications, contraindications, risks, benefits, diagnostic accuracy of the procedure, and its associated morbidity are discussed. The limitations of the available literature are highlighted, and evidence-based recommendations for the use of laparoscopy to stage intraabdominal cancers are provided.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Guidelines for diagnostic laparoscopy. Retrieved March 25, 2008 at http://www.sages.org/sagespublication.php?doc=12

  2. Krasna MJ, Reed CE, Nedzwiecki D, Hollis DR, Luketich JD, DeCamp MM, Mayer RJ, Sugarbaker DJ CALGB, Surgeons Thoracic (2001) CALGB 9380: a prospective trial of the feasibility of thoracoscopy/laparoscopy in staging esophageal cancer. Ann Thorac Surg 71:1073–1079

    Article  PubMed  CAS  Google Scholar 

  3. Heath EI, Kaufman HS, Talamini MA, Wu TT, Wheeler J, Heitmiller RF, Kleinberg L, Yang SC, Olukayode K, Forastiere AA (2000) The role of laparoscopy in preoperative staging of esophageal cancer. Surg Endosc 14:495–499

    Article  PubMed  CAS  Google Scholar 

  4. Bonavina L, Incarvone R, Lattuada E, Segalin A, Cesana B, Peracchia A (1997) Preoperative laparoscopy in management of patients with carcinoma of the esophagus and of the esophagogastric junction. J Surg Oncol 65:171–174

    Article  PubMed  CAS  Google Scholar 

  5. Romijn MG, van Overhagen H, Spillenaar Bilgen EJ, Ijzermans JN, Tilanus HW, Lameris JS (1998) Laparoscopy and laparoscopic ultrasonography in the staging of oesophageal and cardial carcinoma. Br J Surg 85:1010–1012

    Article  PubMed  CAS  Google Scholar 

  6. Krasna MJ, Jiao X, Mao YS, Sonett J, Gamliel Z, Kwong K, Burrows W, Flowers JL, Greenwald B, White C (2002) Thoracosopy/laparoscopy in the staging of esophageal cancer. Surg Laparosc Endosc Percutan Tech 12:213–218

    Article  PubMed  Google Scholar 

  7. D’Ugo DM, Pende V, Persiani R, Rausei S, Picciocchi A (2003) Laparoscopic staging of gastric cancer: an overview. J Am Coll Surg 196:965–974

    Article  PubMed  Google Scholar 

  8. Asencio F, Aguilo J, Salvador JL, Villar A, De la Morena E, Ahamad M, Escrig J, Puche J, Viciano V, Sanmiguel G, Ruiz J (1997) Video-laparoscopic staging of gastric cancer. Surg Endosc 11:1153–1158

    Article  PubMed  CAS  Google Scholar 

  9. Hulscher JBF, Nieveen van Dijkum EJ, de Wit LT, van Delden OM, van Lanschot JJ, Obertop H, Gouma DJ (2000) Laparoscopy and laparoscopic ultrasonography in staging carcinoma of the gastric cardia. Eur J Surg 166:862–865

    Article  PubMed  CAS  Google Scholar 

  10. Gross E, Bancewicz J, Ingram G (1984) Assessment of gastric cancer by laparoscopy. Br Med J 288:1577

    CAS  Google Scholar 

  11. Possik RA, Franco EL, Pires DR, Wohnrath DR, Ferreira EB (1986) Sensitivity, specificity, and predictive value of laparoscopy for the staging of gastric cancer and for the detection of liver metastases. Cancer 58:1–6

    Article  PubMed  CAS  Google Scholar 

  12. Kriplani AK, Kapur BML (1991) Laparoscopy for the preoperative staging and assessment of operability in gastric carcinoma. Gastrointest Endosc 37:441–443

    Article  PubMed  CAS  Google Scholar 

  13. Lowy AM, Mansfield PF, Leach SD, Ajani J (1996) Laparoscopic staging for gastric cancer. Surgery 119:611–614

    Article  PubMed  CAS  Google Scholar 

  14. Burke EC, Karpeh MS, Conlon KC, Brennan MF (1997) Laparoscopy in the management of gastric adenocarcinoma. Ann Surg 225:262–267

    Article  PubMed  CAS  Google Scholar 

  15. Stell DA, Carter CR, Stewart I, Anderson JR (1996) Prospective comparison of laparoscopy, ultrasonography, and computed tomography in the staging of gastric cancer. Br J Surg 86:1260–1262

    Article  Google Scholar 

  16. Conlon KC (2001) Staging laparoscopy for gastric cancer. Ann Ital Chir 72:33–37

    PubMed  CAS  Google Scholar 

  17. Luque-de Leon E, Tsiotos GG, Balsiger B, Barnwell J, Burgart LJ, Sarr MG (1999) Staging laparoscopy for pancreatic cancer should be used to select the best means of palliation and not only to maximize the resectability rate. J Gastrointest Surg 3:111–117

    Article  PubMed  CAS  Google Scholar 

  18. Jimenez RE, Warshaw AL, Rattner DW, Willett CG, McGrath D, Fernandez-Del Castillo C (2000) Impact of laparoscopic staging in the treatment of pancreatic cancer. Arch Surg 135:409–414

    Article  PubMed  CAS  Google Scholar 

  19. Schachter PP, Avni Y, Shimonov M, Gvirtz G, Rosen A, Czerniak A (2000) The impact of laparoscopy and laparoscopic ultrasonography on the management of pancreatic cancer. Arch Surg 135:1303–1307

    Article  PubMed  CAS  Google Scholar 

  20. Minnard EA, Conlon KC, Hoos A, Dougherty EC, Hann LE, Brennan MF (1998) Laparoscopic ultrasound enhances standard laparoscopy in the staging of pancreatic cancer. Ann Surg 228:182–187

    Article  PubMed  CAS  Google Scholar 

  21. Hunerbein M, Rau B, Hohenberger P, Schlag PM (1998) The role of staging laparoscopy for multimodal therapy of gastrointestinal cancer. Surg Endosc 12:921–925

    Article  PubMed  CAS  Google Scholar 

  22. Durup Scheel-Hincke J, Mortensen MB, Qvist N, Hovendal CP (1999) TNM staging and assessment of resectability of pancreatic cancer by laparoscopic ultrasonography. Surg Endosc 13:967–971

    Article  PubMed  CAS  Google Scholar 

  23. Doran HE, Bosonnet L, Connor S, Jones L, Garvey C, Hughes M, Campbell F, Hartley M, Ghaneh P, Neoptolemos JP, Sutton R (2004) Laparoscopy and laparoscopic ultrasound in the evaluation of pancreatic and periampullary tumours. Dig Surg 21:305–313

    Article  PubMed  CAS  Google Scholar 

  24. Pietrabissa A, Caramella D, Di Candio G, Carobbi A, Boggi U, Rossi G, Mosca F (1999) Laparoscopy and laparoscopic ultrasonography for staging pancreatic cancer: critical appraisal. World J Surg 23:998–1002

    Article  PubMed  CAS  Google Scholar 

  25. Awad SS, Colletti L, Mulholland M, Knol J, Rothman ED, Scheiman J, Eckhauser FE (1997) Multimodality staging optimizes resectability in patients with pancreatic and ampullary cancer. Am Surg 63:634–638

    PubMed  CAS  Google Scholar 

  26. Conlon KC, Dougherty E, Klimstra DS, Coit DG, Turnbull AD, Brennan MF (1996) The value of minimal access surgery in the staging of patients with potentially resectable peripancreatic malignancy. Ann Surg 223:134–140

    Article  PubMed  CAS  Google Scholar 

  27. Vollmer CM, Drebin JA, Middleton WD, Teefey SA, Linehan DC, Soper NJ, Eagon CJ, Strasberg SM (2002) Utility of staging laparoscopy in subsets of peripancreatic and biliary malignancies. Ann Surg 235:1–7

    Article  PubMed  Google Scholar 

  28. Pisters PW, Lee JE, Vauthey JN, Charnsangavej C, Evans DB (2001) Laparoscopy in the staging of pancreatic cancer (review, 45 references). Br J Surg 88:325–337

    Article  PubMed  CAS  Google Scholar 

  29. Kwon AH, Inui H, Kamiyama Y (2002) Preoperative laparoscopic examination using surgical manipulation and ultrasonography for pancreatic lesions. Endoscopy 34:464–468

    Article  PubMed  CAS  Google Scholar 

  30. Nieveen van Dijkum EJ, Romijn MG, Terwee CB, de Wit LT, van der Meulen JH, Lameris HS, Rauws EA, Obertop H, van Eyck CH, Bossuyt PM, Gouma DJ (2003) Laparoscopic staging and subsequent palliation in patients with peripancreatic carcinoma. Ann Surg 237:66–73

    Article  PubMed  Google Scholar 

  31. Friess H, Kleeff J, Silva JC, Sadowski C, Baer HU, Buchler MW (1998) The role of diagnostic laparoscopy in pancreatic and periampullary malignancies. J Am Coll Surg 186:675–682

    Article  PubMed  CAS  Google Scholar 

  32. Barreiro CJ, Lillemoe KD, Koniaris LG, Sohn TA, Yeo CJ, Coleman J, Fishman EK, Cameron JL (2002) Diagnostic laparoscopy for periampullary and pancreatic cancer: what is the true benefit? J Gastrointest Surg 6:75–81

    Article  PubMed  Google Scholar 

  33. Liu RC, Traverso LW (2005) Diagnostic laparoscopy improves staging of pancreatic cancer deemed locally unresectable by computed tomography. Surg Endosc 19:638–642

    Article  PubMed  CAS  Google Scholar 

  34. Holzman MD, Reintgen KL, Tyler DS, Pappas TN (1997) The role of laparoscopy in the management of suspected pancreatic and periampullary malignancies. J Gastrointest Surg 1:236–243

    Article  PubMed  CAS  Google Scholar 

  35. Tilleman EH, de Castro SM, Busch OR, Bemelman WA, van Gulik TM, Obertop H, Gouma DJ (2002) Diagnostic laparoscopy and laparoscopic ultrasound for staging of patients with malignant proximal bile duct obstruction. J Gastrointest Surg 6:426–430

    Article  PubMed  Google Scholar 

  36. John TG, Wright A, Allan PL, Redhead DN, Paterson-Brown S, Carter DC, Garden OJ (1999) Laparoscopy with laparoscopic ultrasonography in the TNM staging of pancreatic carcinoma. World J Surg 23:870–881

    Article  PubMed  CAS  Google Scholar 

  37. Callery MP, Strasberg SM, Doherty GM, Soper NJ, Norton JA (1997) Staging laparoscopy with laparoscopic ultrasonography: optimizing resectability in hepatobiliary and pancreatic malignancy. J Am Coll Surg 185:33–39

    PubMed  CAS  Google Scholar 

  38. Bemelman WA, de Wit LT, van Delden OM, Smits NJ, Obertop H, Rauws EJ, Gouma DJ (1995) Diagnostic laparoscopy combined with laparoscopic ultrasonography in staging of cancer of the pancreatic head region (see comment). Br J Surg 82:820–824

    Article  PubMed  CAS  Google Scholar 

  39. Stefanidis D, Grove KD, Schwesinger WH, Thomas CR Jr (2006) The current role of staging laparoscopy for adenocarcinoma of the pancreas: a review. Ann Oncol 17:189–199

    Article  PubMed  CAS  Google Scholar 

  40. Fernandez-del Castillo CL, Warshaw AL (1998) Pancreatic cancer. laparoscopic staging and peritoneal cytology. Surg Oncol Clin North Am 7:135–142

    CAS  Google Scholar 

  41. Fernandez-Del Castillo C, Rattner DW, Warshaw AL (1995) Further experience with laparoscopy and peritoneal cytology in the staging of pancreatic cancer. Br J Surg 82:1127–1129

    Article  PubMed  CAS  Google Scholar 

  42. Schmidt J, Fraunhofer S, Fleisch M, Zirngibl H (2004) Is peritoneal cytology a predictor of unresectability in pancreatic carcinoma? Hepatogastroenterology 51:1827–1831

    PubMed  Google Scholar 

  43. Liu RC, Traverso LW (2004) Laparoscopic staging should be used routinely for locally extensive cancer of the pancreatic head. J Gastrointest Surg 8:923–924

    Article  PubMed  Google Scholar 

  44. Shoup M, Winston C, Brennan MF, Bassman D, Conlon KC (2004) Is there a role for staging laparoscopy in patients with locally advanced, unresectable pancreatic adenocarcinoma? J Gastrointest Surg 8:1068–1071

    Article  PubMed  Google Scholar 

  45. Yoshida T, Matsumoto T, Morii Y, Ishio T, Kitano S, Yamada Y, Mori H (2002) Staging with helical computed tomography and laparoscopy in pancreatic head cancer. Hepatogastroenterology 49:1428–1431

    PubMed  Google Scholar 

  46. Morganti AG, Brizi MG, Macchia G, Sallustio G, Costamagna G, Alfieri S, Mattiucci GC, Valentini V, Natale L, Deodato F, Mutignani M, Doglietto GB, Cellini N (2005) The prognostic effect of clinical staging in pancreatic adenocarcinoma. Ann Surg Oncol 12:145–151

    Article  PubMed  Google Scholar 

  47. Velanovich V (2004) The effects of staging laparoscopy on trocar site and peritoneal recurrence of pancreatic cancer. Surg Endosc 18:310–313

    Article  PubMed  CAS  Google Scholar 

  48. Urbach DR, Swanstrom LL, Hansen PD (2002) The effect of laparoscopy on survival in pancreatic cancer. Arch Surg 137:191–199

    Article  PubMed  Google Scholar 

  49. Connor S, Bosonnet L, Alexakis N, Raraty M, Ghaneh P, Sutton R, Neoptolemos JP (2005) Serum CA19-9 measurement increases the effectiveness of staging laparoscopy in patients with suspected pancreatic malignancy. Dig Surg 22:80–85

    Article  PubMed  CAS  Google Scholar 

  50. Andren-Sandberg A, Lindberg CG, Lundstedt C, Ihse I (1998) Computed tomography and laparoscopy in the assessment of the patient with pancreatic cancer. J Am Coll Surg 186:35–40

    Article  PubMed  CAS  Google Scholar 

  51. Obertop H, Gouma DJ (1999) Essentials in biliopancreatic staging: a decision analysis. Ann Oncol 10(Suppl 4):150–152

    Article  PubMed  Google Scholar 

  52. Jarnagin WR, Bodniewicz J, Dougherty E, Conlon K, Blumgart LH, Fong Y (2000) A prospective analysis of staging laparoscopy in patients with primary and secondary hepatobiliary malignancies. J Gastrointest Surg 4:34–43

    Article  PubMed  CAS  Google Scholar 

  53. Lo CM, Lai EC, Liu CL, Fan ST, Wong J (1998) Laparoscopy and laparoscopic ultrasonography avoid exploratory laparotomy in patients with hepatocellular carcinoma. Ann Surg 227:527–532

    Article  PubMed  CAS  Google Scholar 

  54. Foroutani A, Garland AM, Berber E, String A, Engle K, Ryan TL, Pearl JM, Siperstein AE (2000) Laparoscopic ultrasound vs. triphasic computed tomography for detecting liver tumors. Arch Surg 135:933–938

    Article  PubMed  CAS  Google Scholar 

  55. Weber SM, DeMatteo RP, Fong Y, Blumgart LH, Jarnagin WR (2002) Staging laparoscopy in patients with extrahepatic biliary carcinoma. Ann Surg 235:392–399

    Article  PubMed  Google Scholar 

  56. Tilleman EH, de Castro SM, Busch OR, Bemelman WA, van Gulik TM, Obertop H, Gouma DJ (2002) Diagnostic laparoscopy and laparoscopic ultrasound for staging of patients with malignant proximal bile duct obstruction. J Gastroint Surg 6:426–430

    Article  Google Scholar 

  57. van Delden OM, de Wit LT, Nieveen van Dijkum EJM, Smits NJ, Gouma DJ, Reeders JW (1997) Value of laparoscopic ultrasonography in staging of proximal bile duct tumors. J Ultrasound Med 16:7–12

    PubMed  Google Scholar 

  58. Connor S, Barron E, Wigmore SJ, Madhavan KK, Parks RW, Garden OJ (2005) The utility of laparoscopic assessment in the preoperative staging of suspected hilar cholangiocarcinoma. J Gastrointest Surg 9:476–480

    Article  PubMed  Google Scholar 

  59. Thaler K, Kanneganti S, Khajanchee Y, Wilson C, Swanstrom L, Hansen PD (2005) The evolving role of staging laparoscopy in the treatment of colorectal hepatic metastasis. Arch Surg 140:727–734

    Article  PubMed  Google Scholar 

  60. Jarnagin WR, Conlon K, Bodniewicz J, Dougherty E, Dematteo RP, Blumgart LH, Fong Y (2001) A clinical scoring system predicts the yield of diagnostic laparoscopy in patients with potentially resectable hepatic colorectal metastases. Cancer 91:1121–1128

    Article  PubMed  CAS  Google Scholar 

  61. Milsom JW, Jerby BL, Kessler H, Hale JC, Herts BR, O’Malley CM (2000) Prospective, blinded comparison of laparoscopic ultrasonography vs contrast-enhanced computerized tomography for liver assessment in patients undergoing colorectal carcinoma surgery. Dis Colon Rectum 43:44–49

    Article  PubMed  CAS  Google Scholar 

  62. Goletti O, Celon G, Galatioto C, Viaggi B, Lippolis PV, Pieri L, Cavina E (1998) Is laparoscopic sonography a reliable and sensitive procedure for staging colorectal cancer? Surg Endosc 12:1236–1241

    Article  PubMed  CAS  Google Scholar 

  63. Rahusen FD, Cuesta MA, Borgstein PJ, Bleichrodt RP, Barkhof F, Doesburg T, Meijer S (1999) Selection of patients for resection of colorectal metastases to the liver using diagnostic laparoscopy and laparoscopic ultrasonography. Ann Surg 230:31–37

    Article  PubMed  CAS  Google Scholar 

  64. Asoglu O, Porter L, Donohue JH, Cha SS (2005) Laparoscopy for the definitive diagnosis of intraabdominal lymphoma. Mayo Clin Proc 80:625–631

    Article  PubMed  Google Scholar 

  65. Baccarani U, Carroll BJ, Hiatt JR, Donini A, Terrosu G, Decker R, Chandra M, Bresadola F, Phillips EH (1998) Comparison of laparoscopic and open staging in Hodgkin’s disease. Arch Surg 133:517–522

    Article  PubMed  CAS  Google Scholar 

  66. Silecchia G, Raparelli L, Perrotta N, Fantini A, Fabiano P, Monarca B, Basso N (2003) Accuracy of laparoscopy in the diagnosis and staging of lymphoproliferative diseases. World J Surg 27:653–658

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to L. Chang.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chang, L., Stefanidis, D., Richardson, W.S. et al. The role of staging laparoscopy for intraabdominal cancers: an evidence-based review. Surg Endosc 23, 231–241 (2009). https://doi.org/10.1007/s00464-008-0099-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-008-0099-2

Keywords

Navigation