[The role of laparoscopy and laparoscopic ultrasonography in the diagnosis and differential diagnosis of nodular hepatocellular lesions].
The diagnostic relevance of laparoscopy (LS) and laparoscopic echography (LE) in nodular hepatocellular lesions is studied. LS is done using a R. Wolf laparoscope, and LE--with a 7.5 MHz linear transducer, obtained from the Aloka Company. A total of 250 patients presenting 288 nodular hepatocellular lesions are investigated over 15 years (1983-1998), including: focal nodular hyperplasia (FNH)--1, nodular regenerative hyperplasia (NRH)--1, hepatocellular adenoma (HCA)--1, adenomatous hyperplasia (AH)--38, hepatocellular carcinoma (HCC)--58, Budd-Chiari syndrome--2, primary sclerosing cholangitis (PSCh)--2, and cirrhosis of liver--185. The lesions are distributed according to the updated classification of the International Working Party, published in 1995. In addition to the latter, a case of cholangiocellular adenoma undergoing malignant degeneration and a case presenting carcinoma, giving rise to differential diagnostic difficulties are also described. Some of the aforementioned diseases are reported for the first time in the Bulgarian literature. Emphasis is laid on the practicability of combining endoscopic with imaging diagnostics, attributable to laparoscopic echography and to the advantages of echolaparoscopic biopsy. Almost half of the foci (46.1%) are morphologically verified. The aim of cytological assessment is to establish the malignant character of the lesion, first and foremost, while the histological finding is essential for making a correct diagnosis.
*University Hospital "Queen Joanna," Clinical Center of Gastroenterology, Sofia, Bulgaria.
N
N
Krastev
N
N
Grigorov
L
L
Dinkov
Y
Y
Genov
R
R
Mitova
M
M
Donov
D018248:Adenoma, Liver Cell / Q000473:pathology; D000293:Adolescent; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D005260:Female; D020518:Focal Nodular Hyperplasia / Q000473:pathology; D006801:Humans; D010535:Laparoscopy; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000000981:diagnostic imaging; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D014463:Ultrasonography