title: Staging laparoscopy for cholangiocarcinoma.
abstract: The precise role of laparoscopic assessment of biliary tract malignancy is yet to be defined. The evidence for its use has been reviewed to establish the role of laparoscopy for preoperative staging of cholangiocarcinoma. Published papers were reviewed for the evidence relevant to intrahepatic, proximal intrahepatic and distal biliary carcinoma. There is no randomized trial evaluating staging laparoscopy or laparoscopic ultrasound in the assessment of cholangiocarcinoma and the quality of the available data is extremely variable. There is a need for further studies to determine the specific role of laparoscopic staging of cholangiocarcinoma. The current standard of management should be to perform laparoscopic staging prior to proceeding to resection for patients with cholangiocarcinoma as it may prevent unnecessary laparotomy in up to 30% of patients. However, a selective approach identifying high-risk patients who will not benefit from surgical palliation may be more cost effective and future studies should be performed to identify such patients.
authors.affiliation: Beth Israel Deaconess Medical Center, Boston, Mass., USA.
authors.forename: S
authors.initials: S
authors.lastname: Joseph
authors.forename: S
authors.initials: S
authors.lastname: Connor
authors.forename: O J
authors.initials: OJ
authors.lastname: Garden
references.citation: Br J Surg. 2002 Dec;89(12):1525-31
references.pmid: 12445060
references.citation: Surg Endosc. 2006 May;20(5):721-5
references.pmid: 16508808
references.citation: Ann Surg. 2002 Mar;235(3):392-9
references.pmid: 11882761
references.citation: Ann Surg. 2002 Jan;235(1):1-7
references.pmid: 11753036
references.citation: J Am Coll Surg. 1997 Jul;185(1):33-9
references.pmid: 9208958
references.citation: Ann Surg. 2001 Oct;234(4):507-17; discussion 517-9
references.pmid: 11573044
references.citation: J Gastrointest Surg. 2005 Apr;9(4):476-80
references.pmid: 15797226
references.citation: J Gastrointest Surg. 2007 Nov;11(11):1488-96; discussion 1496-7
references.pmid: 17805937