Guidelines for the appropriate use of endoscopy are based on a critical review of the available data and expert consensus. Controlled clinical studies are needed to clarify aspects of this statement, and revision may be necessary as new data appear. Clinical considerations may justify a course of action at variance from these recommendations. The addition of directed biopsy increases diagnostic accuracy. Laparoscopy is simple, safe, and well-tolerated under local anesthesia.
General anesthesia is neither necessary nor desirable, except in special circumstances.
The procedure may be performed on an outpatient basis, although more commonly it is an inpatient procedure. In the final analysis, local experience and results will determine the preference for each of these diagnostic modalities 3-4. Indications Laparoscopy may be useful in the evaluation of suspected hepatic malignancy either primary or metastatic5-6. Blind percutaneous liver biopsy or image-guided needle aspirate biopsy is frequently employed as the initial diagnostic modality for suspected hepatic malignancy. Laparoscopy is appropriate when hepatic tumor is suspected but not proven by percutaneous biopsy techniques.