THE ROLE OF LAPAROSCOPY IN DIAGNOSIS AND TREATMENT OF PRIMARY OR METASTATIC LIVER-CANCER

Laparoscopy is considered a modality complimentary to the current staging techniques. Radiology offers sophisticated evaluations such as CT, MRI, ultrasound, and invasive vascular radiologic procedures. Laparoscopy when applied appropriately can provide a diagnosis with increased accuracy and eliminate unnecessary delays in formulating a treatment plan. If a patient appears to have a resectable lesion or lesions and is deemed an acceptable surgical candidate, it is appropriate for laparoscopy to be performed just prior to opening the abdomen for purposes of hepatic resection. The techniques of biopsy, laparoscopic intra-abdominal ultrasound, and the limitations of laparoscopy are discussed in detail. Lastly, the role of laparoscopic hepatic resection and its application, particularly in superficial or peripheral lesions, is presented. The role of laparoscopy in hepatic lesions is evolving where it is obvious that it offers benefits not available through other means in evaluating the liver tumor. (C) 1994 Wiley-Liss, Inc.