title: Routine staging laparoscopy has no place in the management of colorectal liver metastases.
abstract: OBJECTIVE
  Staging laparoscopy has been recommended in the management of patients with colorectal liver metastases prior to hepatectomy in order to reduce the incidence and associated morbidity of futile laparotomies. The utility of staging laparoscopy has not been assessed in patients undergoing CT, PET-CT and MRI as standard preoperative staging.
  
  
  METHODS
  All patients undergoing attempted open hepatectomy for colorectal liver metastases between 1/4/2008 and 31/3/2012 were identified from a prospectively maintained research database. All patients who underwent futile laparotomy were identified, with demographics and operative notes subsequently analysed.
  
  
  RESULTS
  A total of 274 patients underwent attempted open hepatectomy during the study period. At laparotomy 12 (4.4%) patients were found to have irresectable disease. There were no unifying demographic factors within the patients undergoing futile laparotomy.
  
  
  CONCLUSIONS
  With modern imaging, the potential yield of staging laparoscopy is low. Staging laparoscopy should not be used routinely, but may have a role in the case of specific clinical concerns.
authors.affiliation: Northwestern Hepatobiliary Unit, University Hospital Aintree, Longmoor Lane, Liverpool L9 7AL, United Kingdom. ddunne@nhs.net
authors.forename: D F J
authors.initials: DF
authors.lastname: Dunne
authors.forename: J
authors.initials: J
authors.lastname: Gaughran
authors.forename: R P
authors.initials: RP
authors.lastname: Jones
authors.forename: D
authors.initials: D
authors.lastname: McWhirter
authors.forename: P A
authors.initials: PA
authors.lastname: Sutton
authors.forename: H Z
authors.initials: HZ
authors.lastname: Malik
authors.forename: G J
authors.initials: GJ
authors.lastname: Poston
authors.forename: S W
authors.initials: SW
authors.lastname: Fenwick
mesh_terms: D000368:Aged; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D016208:Databases, Factual; D003955:Diagnostic Tests, Routine; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000379:methods* / Q000401:mortality; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007813:Laparotomy / Q000379:methods; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000556:secondary*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging / Q000009:adverse effects / Q000379:methods*; D049268:Positron-Emission Tomography; D011300:Preoperative Care / Q000379:methods; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed