title: Mini-laparoscopy is superior in detecting liver cirrhosis and metastases in liver cancer: an over 10-year experience in 1,788 cases.
abstract: OBJECTIVE
  Mini-laparoscopy has, since its first description in 1998, proven to be a valuable diagnostic method in liver diseases. We re-evaluated the significance of mini-laparoscopy for diagnosis and staging of liver disease and primary liver and bile duct cancer.
  
  
  METHODS
  1,788 consecutive patients who received a diagnostic mini-laparoscopy between 10/1998 and 06/2011 were included in this retrospective cohort study.
  
  
  RESULTS
  In chronic liver disease, cirrhosis was detected by mini-laparoscopy in 27% of cases. A comparison of microscopic versus macroscopic diagnosis of cirrhosis revealed a sampling error for histology alone of 21%. Macroscopic inspection of the liver surface contributed to the diagnosis of unknown liver diseases in approximately 38%. In patients with bile duct or liver cancer, mini-laparoscopy led to upstaging of the disease in 33 and 23%, respectively. Major complications (bowel perforation and delayed bleeding) occurred in 0.39% of cases.
  
  
  CONCLUSIONS
  Mini-laparoscopy is a valuable procedure with significant diagnostic impact in known and unknown inflammatory and malignant liver diseases. It can be safely performed even in patients with acute liver failure and severe coagulopathy and the diagnostic value does not differ from diagnostic laparoscopy performed with standard instruments.
authors.affiliation: Department for Gastroenterology and Hepatology, University Hospital Essen, Essen, Germany.
authors.forename: Philip
authors.initials: P
authors.lastname: Hilgard
authors.forename: Alexander
authors.initials: A
authors.lastname: Dechene
authors.forename: Ali
authors.initials: A
authors.lastname: Canbay
authors.forename: Kerstin
authors.initials: K
authors.lastname: Herzer
authors.forename: Jörg F
authors.initials: JF
authors.lastname: Schlaak
authors.forename: Ulrich
authors.initials: U
authors.lastname: Treichel
authors.forename: Andrea M
authors.initials: AM
authors.lastname: Gassel
authors.forename: Hideo
authors.initials: H
authors.lastname: Baba
authors.forename: Thomas
authors.initials: T
authors.lastname: Zoepf
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000473:pathology*; D001706:Biopsy; D006528:Carcinoma, Hepatocellular / Q000473:pathology* / Q000556:secondary; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000473:pathology*; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000473:pathology*; D017114:Liver Failure, Acute / Q000175:diagnosis; D008113:Liver Neoplasms / Q000473:pathology* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010534:Peritoneal Neoplasms / Q000556:secondary*; D012189:Retrospective Studies; D055815:Young Adult