Role of diagnostic laparoscopy in management of hepatobiliary malignancy: Prospective analysis

ABSTRACT

In this study, 100 patients were subjected to diagnostic laparoscopy [DL] to assess the respectability of their hepatocellular carcinoma. All patients were considered to be candidates for resection on the basis of preoperative imaging studies. Seven laparoscopic cases were incomplete due to adhesions. Eighteen patients were found to be unresectable at laparoscopy. Of the remaining 75 patients, 11 turned to be unresectable at open exploration yielding 14.7% false-negative rate. Laparoscopy identified 18 of 29 patients with unresectable disease. Laparoscopy was most accurate for identifying liver cirrhosis, peritoneal disease, additional hepatic disease and verifying the actual size of the tumor which is not accurately determined by the imaging techniques. On the other hand, laparoscopy was the least accurate method for vascular invasion and lymph node metastases. Adding laparoscopic ultrasound [LUS] to the DL technique can be valuable in tracing vascular invasion or finding additional hepatic tumors