Role of staging laparoscopy in the treatment of hepatic malignancy

Am J Surg. 1994 Jan;167(1):151-4; discussion 154-5. doi: 10.1016/0002-9610(94)90066-3.

Abstract

Despite current radiologic imaging capabilities, 40% to 70% of patients with primary or metastatic hepatic malignancies are found to have unresectable disease at the time of laparotomy. The present study evaluates the use of laparoscopy in the staging of hepatic malignancy. Twenty-nine patients underwent staging laparoscopy prior to a planned laparotomy for resection of a hepatic malignancy that was deemed resectable by computed axial tomographic scan and ultrasonography. Twelve patients had primary hepatic malignancies, and 17 had metastatic malignancies. Laparoscopy demonstrated evidence of unresectability in 48% (14 of 29) of patients studied. Four patients had unsuspected cirrhosis, and 10 had unresectable or extrahepatic metastatic disease. Patients who underwent laparoscopy alone had shorter mean hospital lengths of stay than historical controls who underwent laparotomy alone. We conclude that diagnostic laparoscopy should precede laparotomy for planned resection of hepatic malignancies.

MeSH terms

  • Carcinoma, Hepatocellular / pathology*
  • Carcinoma, Hepatocellular / surgery
  • Colorectal Neoplasms / pathology
  • Diagnostic Imaging
  • Evaluation Studies as Topic
  • Female
  • Humans
  • Laparoscopy*
  • Laparotomy
  • Length of Stay
  • Liver / pathology
  • Liver Cirrhosis / diagnosis
  • Liver Neoplasms / pathology*
  • Liver Neoplasms / secondary
  • Liver Neoplasms / surgery
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Sensitivity and Specificity