Die laparoskopische Diagnose des primären Leberkarzinoms

Summary

A total of 46 primary cancers of the liver was found in a survey of 673 peritoneoscopies performed between 1965–1969. The 41 hepatocellular, 4 cholangiocellular cancers and 1 primary hepatic melanoma observed in 36 men and 10 women arose in all but 2 cases in a cirrhotic liver. The peritoneoscopic appearance of the massive, nodular and diffuse forms of primary cancer of the liver is described and illustrated by photographs. The diagnosis is confirmed by directed biopsy. If difficulties are encountered in the histological evaluation of the liver biopsy specimens, autoradiographic observation of the rate of DNA synthesis by the liver cells and the electronmicroscopic examination of the tumour cells may be of considerable value. The findings point to the importance of peritoneoscopic investigation in patients with cirrhosis of the liver. On such examinations indices of primary liver cancer should be sought for and biopsy specimens should be taken from regions suspected to be tumourous.

Key-Words

Peritoneoscopy - liver biopsy - primary liver cancer - liver cirrhosis - DNA synthesis in the liver - liver-cell autoradiography