Exposure during pancreatic surgery. Do we have to examine the falciform and round ligaments for XXXX @entity3 ?

@entity1 @entity788 @entity8 @entity5 @entity3
CONTEXT: Metastatic and locally advanced disease is unfortunately a common clinical occurrence in @entity1 affected by @entity788 . The most frequent sites of @entity3 are the liver and the peritoneal lining. The falciform and round ligaments are routinely resected and sent for pathology, but no @entity3 have ever been reported. OBJECTIVE: In this study, we assess whether the falciform and round ligaments are possible sites for @entity3 and if routine pathology examination of these structures is justified. DESIGN: Retrospective, single institution study. @entity1 : The charts of all @entity1 who underwent pancreatic resection from June 2005 through January 2011 were reviewed retrospectively. Data on age, gender, type of operation performed, preoperative CA 19-9 levels, vascular and perineural invasion, @entity5 differentiation and pathological staging were retrieved from the hospital electronic data base. Only @entity1 with @entity8 were included in the study. MAIN OUTCOME MEASURES: Presence of pancreatic @entity3 in the falciform and round ligaments. RESULTS: Fifty-seven @entity1 were included in the study. Forty @entity1 had undergone pancreaticoduodenectomies, 10 subtotal pancreatectomies, 2 total pancreatectomies, and 1 distal pancreatectomy. Four @entity1 had exploratory laparotomy but exploration revealed @entity5 , thus the planned resection was not carried out. The falciform and round ligaments were all negative for @entity3 in all @entity1 . DISCUSSION: Metastatic progression of @entity788 is poorly understood. Theoretically, @entity3 to the falciform and round ligaments could occur by either contiguous, hematogenic or lymphatic spread. In our study, none of the @entity1 had @entity3 to the falciform and round ligaments, regardless of the pathological staging. CONCLUSION: We concluded that routine pathological examination of the falciform and round ligaments is not justified if the surgeon elects to remove the structures for ease of exploration and retraction during surgery. This may lighten the workload and reduce costs in a busy pathology laboratory.
