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Abstract
Primary and metastatic tumors of the liver continue to present a therapeutic challenge.
Accurate and precise staging of malignant tumors in the liver is required to define the optimum therapeutic strategy.
In spite of technical advances, the sensitivity of conventional imaging techniques is inadequate to provide precise staging of malignant neoplasm of the liver. Abdominal ultrasound and CT scan often fail to detect many lesions including superficial and sub capsular lesions, subcentimetric (less than 1 cm) lesions, satellites around the primary, peritoneal nodules and intra peritoneal dissemination (1).
The introduction of minimally invasive surgical techniques presents the potential to avoid unnecessary laparotomies and to determine the extent of resection in patients with hepatic malignant neoplasm (2).
The combination of diagnostic laparoscopy and laparoscopic ultrasound provides additional essential information for more accurate staging of the disease.
As laparoscopic inspection demonstrates the liver condition and excludes the presence of multifocal tumor or any extrahepatic tumor spread.
While laparoscopic ultrasonography provides more accurate information, since the probe comes in direct contact with the liver tissue with no intervening layers in between (3).
Diagnostic laparoscopy and laparoscopic ultrasound should be used as an adjunct to preoperative imaging studies in the staging of patients with primary or metastatic hepatic neoplasm to determine both surgical and nonsurgical therapeutic strategies (4).