USEFULNESS OF LAPAROSCOPY IN EVALUATION O F THE SPREAD OF GASTROINTESTINAL CARCINOMAS

Sixty two patients with a gastrointestinal carcinoma were evaluated pr e-operatively by ultrasonography, CT scan and laparoscopy to seek live r metastases and/or peritoneal carcinomatosis. Performance levels of l aparoscopy, ultrasonography and CT scan were comparable regarding the diagnosis of liver metastases. Laparoscopy was markedly better than CT scan and ultrasonography in the diagnosis of peritoneal carcinomatosi s. Thus the investigation of choice for the detection of liver metasta ses is a single imaging technique. In contrast, if excision surgery is envisaged, all gastrointestinal carcinomas should be assessed by ultr asonography and/or CT scan and laparoscopy to definitely eliminate per itoneal carcinomatosis or small superficial liver metastases, in such a way as to avoid unnecessary laparotomy.