[Secondary cancer of the liver: value and efficacy of laparoscopy]

The indications for laparoscopy have been greatly reduced by the development of ultrasonography. However, laparoscopy is still indicated in secondary cancer of the liver, as it can provide histological proof of the diagnosis by means of biopsies taken under direct vision. It is therefore more effective than the non-invasive morphological examinations, but, in the future, it may be replaced by ultrasound guided biopsies. In general, laparoscopy only confirms a diagnosis which is very probable on the basis of clinical and laboratory data. Furthermore, it is very unlikely that laparoscopy will reveal small metastases; this is due to the multicentric nature of hepatic metastases, rather than to a deficiency in the investigation itself.