[Malignant hepatobiliary tumors. Surgical requirements concerning preoperative diagnosis].
Depending on the results of the diagnostic work-up of a hepatobiliary tumour, the further therapeutic strategy may vary appreciably. The data needed to decide whether a malignant growth is resectable or not include information on the nature, size and location of the tumour, the number of lesions presenting, extrahepatic tumour-related manifestations, the individual hepatic anatomy and additional liver diseases. Despite the recent technical advances, the various diagnostic imaging procedures all have their limitations; used in combination, however, they can provide adequate information in 90-100% of the cases. The most important of these procedures are ultrasonography and spiral CT--including the use of contrast agents--and in some cases also MRT. Thanks to the topographic information they provide, the three-dimensional methods are gaining popularity. While angiography, scintigraphy and ERCP are useful supplementary methods, they do not suffice for the primary diagnosis. In some cases, intra-operative diagnosis may make necessary a change in the planned therapeutic procedure. The limitations and possibilities of the diagnostic strategy--which in no small part is also codetermined by the patient's prehistory and the experience of the examiner--are discussed.
Köckerling
F
F
Chirurgische Klinik, Klinikum Hannover-Siloah.
Schug-Pass
C
C
Weskott
H P
HP
Tatchen
R
R
D000328:Adult; D000368:Aged; D000792:Angiography; D001650:Bile Duct Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D001653:Bile Ducts, Intrahepatic; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D018281:Cholangiocarcinoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003937:Diagnosis, Differential; D005260:Female; D005706:Gallbladder Neoplasms / Q000175:diagnosis; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D011877:Radionuclide Imaging; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional