Peritoneoscopic diagnosis of hepatocellular carcinoma

In the past ten years, using various types of peritoneoscope and light source produced by Machida Company, a total of 962 cases of peritoneoscopic examinations were carried out on patients with hepatobiliary diseases, ascites of unknown causes and abdominal tumors. Among 962 cases of peritoneoscopy, 241 cases of the new growth of the liver were obtained. Among a total of 241 cases of liver malignacy, there were 180 (74.7%) cases of hepatocellular carcinoma (HCC); 47 (19.5%) cases of metastatic carcinoma of the liver; 7 (2.9%) cases of cholangiocellular carcinoma. A total of 147 (81.7%) out of 180 cases of HCC were observed associated with liver cirrhosis. HCC was male predominant, the ratio being 8.5:1 between the male and the female. The predominant age of HCC ranged from 40 to 60. The main peritoneoscopic finding of HCC was that the protruding main tumor was covered by the greater omentum in about one fourth of the patients with HCC. Peritoneoscopically, we classified HCC into massive, nodular, diffuse and unclassified types. We think that the peritoneoscopic classification is helpful for determining the resectability of the tumor. Through the experiences with 241 cases of peritoneoscopic diagnosis of the new growth of the liver, we have been trying to make the diagnostic criteri-a of HCC and other neoplasm of the liver. The establishment of the diagnostic criteria can easily make a differential diagnosis of HCC from other liver diseases.