title: [The role of laparoscopy assessing the resectability of hepatic malignancies].
abstract: BACKGROUND
  Regarding the prognosis of hepatic malignancies, surgical resection can provide a 40% 5-year survival, however liver transplantation (OLTX) shows even better results. Unfortunately, many patients have non-resectable disease due to either the number and the position of the tumours or its distant spread. It is relatively frequent that it turns out only at the time of the surgical exploration that the patient is inoperable. Hence, in addition to preoperative clinical evaluation and imaging, laparoscopy can be valuable in further staging and assessment of resectability in selected cases.
  
  
  METHODS
  310 patients underwent hepatic resection between 1 January 2000 and 31 March 2006. A retrospective analysis was carried out of 39 patients, who underwent laparoscopy prior to the planned hepatectomy. 22 patients (56%) were diagnosed with hepatocellular carcinoma (HCC), while 17 patients (44%) had hepatic metastases.
  
  
  RESULTS
  Altogether 70% of the patients were found to have non-resectable tumour on laparoscopy. However, when these patients underwent laparotomy, non-resectable disease was found in 50% of them. Laparoscopy was helpful to demonstrate non-resectability of the tumour when carcinosis peritonei or multifocal lesions were present, but central or venous invasion could not be assessed adequately with this technique.
  
  
  CONCLUSIONS
  Laparoscopy can be an important component of the preoperative staging of malignant hepatic tumours. Further, it can help to avoid unnecessary laparotomies. However, this procedure is recommended in selected patients only, and its general use is not indicated.
authors.affiliation: Fovárosi Onkormányzat Uzsoki utcai Kórház, Sebészeti-Ersebészeti Osztály, 1145 Budapest, Uzsoki u. 29. dede.kristof@uzsoki.hu
authors.forename: Kristóf
authors.initials: K
authors.lastname: Dede
authors.forename: Tamás
authors.initials: T
authors.lastname: Mersich
authors.forename: Péter
authors.initials: P
authors.lastname: Nagy
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Baranyai
authors.forename: Attila
authors.initials: A
authors.lastname: Zaránd
authors.forename: István
authors.initials: I
authors.lastname: Ifj Besznyák
authors.forename: Sándor
authors.initials: S
authors.lastname: Faludi
authors.forename: Ferenc
authors.initials: F
authors.lastname: Jakab
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D010535:Laparoscopy; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome