Laparoscopy in carcinoma of the gallbladder

Twenty-three patients with gallbladder carcinoma were critically evaluated by laparoscopy. The diagnosis was confirmed in each case by either histology, cytology, or laparotomy. Direct evidence of carcinoma was present in 15 (65%) and indirect in eight (35%) patients. Cytology alone was positive in 80%, biopsy alone was positive in 60%, and the two techniques in combination yielded tissue diagnosis in 86% of patients having direct evidence. The yield of positive biopsy or cytology was low in cases with indirect evidence. Laparoscopy also circumvented laparotomy in 39% of patients because of the finding of multiple metastatic lesions over the liver surface.