AI Article Synopsis
- A study was conducted to assess if using laparoscopy with laparoscopic ultrasound could prevent unnecessary surgeries in patients needing liver operations while ensuring no treatable diseases are overlooked.
- During the study, 31 patients were evaluated with both techniques, where laparoscopic ultrasound identified 50 malignant lesions accurately with no false positives.
- The findings suggested that in some cases (10% of patients), unnecessary laparotomy could have been avoided, highlighting the potential of laparoscopy and ultrasound to improve surgical outcomes.
Article Abstract
A prospective study was undertaken to determine whether the use of laparoscopy plus laparoscopic ultrasound examination can avoid unnecessary laparotomy, without missing potentially curable disease, in patients scheduled for curative liver surgery. Thirty-one consecutive patients who underwent surgery for planned curative liver surgery were prospectively evaluated by means of both laparoscopy plus laparoscopic ultrasound and laparotomy with intraoperative ultrasound. Laparoscopic ultrasound examination of the liver could not be performed in two patients, and in two other patients only partial examinations were possible because of dense adhesions. All patients underwent laparotomy with intraoperative ultrasound. A total of 50 malignant lesions were identified by laparoscopic ultrasound. All of these lesions were confirmed to be malignant at laparotomy with intraoperative ultrasound, that is, there were no false positive results. An additional four malignant lesions in four patients were not seen at laparoscopic ultrasound examination but were identified at laparotomy with intraoperative ultrasound (sensitivity 93%, specificity 100%, positive predictive value 100%, negative predictive value 85%). Based on the laparoscopic ultrasound findings, nontherapeutic laparotomy could have been avoided in 10% of our patients. Laparoscopy with laparoscopic ultrasound is a promising technology that may allow some patients to avoid a nontherapeutic laparotomy without significant risk of missing potentially curable disease.
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| http://dx.doi.org/10.1016/s1091-255x(97)80102-3 | DOI Listing |
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