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PubMed1975

Pseudomyxoma peritonei diagnosed by peritoneoscopy.

A case of pseudomyxoma peritonei diagnosed by peritoneoscopy is reported. The rarity of the tumour and the unfamiliarity of the surgeon with the vagaries of this condition often lead to a pessimistic diagnosis of advanced metastatic mucinous adenocarcinoma. It is suggested that peritoneoscopy may be of help both in the early diagnosis of pseudomyxoma peritonei, thus sparing patients from unnecessary investigations, and in their follow up, especially when the aggressive policy of multiple repeated resections of the recurrent or persistent lesions is to be adopted.

Cystadenoma↗

PubMed1974

A comparison of the accuracy of peritoneoscopy and liver biopsy in the diagnosis of cirrhosis.

The accuracy of peritoneoscopy and liver biopsy in the diagnosis of hepatic cirrhosis was compared in 473 consecutive patients submitted to both procedures. One hundred and fifty-two of them had cirrhosis diagnosed by one or both methods. There was 73% agreement between the two procedures. ;Apparent' false-negative results were 17.7% for peritoneoscopy and 9.3% for liver biopsy. The incidence of false-negative results in the diagnosis of cirrhosis can be reduced by combining both procedures.

Alcohol Drinking↗

PubMed1983

Peritoneoscopy of the liver after abdominal surgery.

The incidence of intraperitoneal adhesion after abdominal surgery was studied. Peritoneoscopy was performed in 933 patients with liver diseases over the 6 year 5 month period from March 1974 to July 1980. Of the patients, 352 (37.7%) had undergone an abdominal operation, and intraperitoneal adhesion was detected in 205 (58.2%) of these patients. The liver was not observable in 5 out of 61 patients with adhesions after upper abdominal operations. Whereas, the liver was clearly observable in patients with lower abdominal operations in spite of adhesions. Out of the 581 patients without any abdominal operations, 30 patients (5.2%) had adhesions in the abdominal cavity, and 6 of them had extensive adhesions that partially obscured the observation of liver surface. In all patients, peritoneoscopy was performed without complications by avoiding the surgical scar for puncture sites and ensuring a free air lumen before trocar puncture.

Abdomen↗

PubMed1981

The role of peritoneoscopy in the diagnosis of acute abdominal conditions.

We have reported our experience with peritoneoscopy in patients with blunt abdominal trauma and in patients with suspected acute appendicitis. In our experience, the technique was associated with negligible morbidity and was effective in avoiding unnecessary laparotomy when properly applied. We believe that peritoneoscopy has not yet achieved its rightful place as a diagnostic procedure.

Abdomen, Acute↗

PubMed1975

[Peritoneoscopy in differential diagnosis of jaundice].

162 endoscopic studies were conducted in 158 patients. It was found that in obscure cases peritoneoscopy could be successfully employed for differential diagnosis between mechanic and parenchymatous jaundice. Irrespective of the duration of jaundice a reliable information can be obtained endoscopically, in particular in bilirubinemia being over 5 mg%. A peritoneoscopic conclusion as to the character of jaundice was correct in 87% of cases. By means of peritoneoscopy, judging by the appearance of the liver, one could have an idea about the site and character of obturation of bile ducts in over a half of patients.

Adolescent↗

PubMed1976

Congenital fibrosis of the liver: diagnostic possibilities of peritoneoscopy and splenoportography.

Congenital fibrosis of the liver can be tentatively diagnosed by direct-vision peritoneoscopy, and this diagnosis can be verified without difficulty by a liver puncture under peritoneoscopic control. In addition, peritoneoscopy makes it possible to determine portal pressure in the spleen under optical control of the puncture site, and to make a splenoportogram at minimum risk. The splenoportogram supplies information on the luminal width of the splenic and portal veins, which is important if a shunt operation is contemplated. Besides, information can be obtained on the extent of the collateral circulation, and the features of the portal branches in the liver can in turn corroborate the diagnosis.

Adolescent↗

PubMed1978

Peritoneoscopy for the diagnosis of left lobe lesions of the liver.

Peritoneoscopy and direct-vision liver biopsy are simple, safe, and accurate methods for the documentation of focal lesions predominantly involving the left lobe of the liver or the left portion of the right lobe. Focal lesions of the left lobe of the liver constitute a major indication for peritoneoscopy and direct-vision biopsy of the liver when its use is not contraindicated and when blind percutaneous biopsy or biopsies and cytologic examination have failed to establish the diagnosis.

Adenocarcinoma↗

PubMed1978

Peritoneoscopy: an alternative approach to unresolved intra-abdominal disease.

Peritoneoscopy was performed in 49 patients with ill-defined intra-abdominal disease. The patients were classified into categories including inconclusive liver scans, jaundice, ascites, abdominal mass and staging for Hodgkin's disease. Visual evaluation of lesions and directed biopsies led to the correct diagnosis in 87% of the cases. In experienced hands, peritoneoscopy is a safe and useful technic and should be considered strongly in obscure intra-abdominal diseases.

Abdominal Neoplasms↗

PubMed1978

Peritoneoscopy in the management of breast cancer.

Peritoneoscopy has been recommended by the Combined Breast Clinic at the Provincial Hospital, Port Elizabeth, since 1975, mainly to confirm or exclude metastatic involvement of the liver. Experience with 27 procedures is reviewed. Peritoneoscopy is shown to be a useful aid in the staging and management of selected cases of breast cancer. Positive findings, confirmed by histological examination, were recorded for 5 patients. Negative findings in 22 patients were equally helpful, and were found to be reliable, in that none of these patients had evidence of liver involvement during the follow-up period, while in 5 patients there was evidence of metastases elsewhere.

Breast Neoplasms↗

PubMed1979

[Peritoneoscopy in infancy and childhood, indications, technique and diagnostic value (author's transl)].

Indications, technique and diagnostic value of peritoneoscopy in infancy and childhood are reviewed from the literature; own results are discussed as well. Peritoneoscopy is an important procedure in the diagnosis of chronic inflammatory liver disease and gonadal dysgenesis in this age group. If other diseases are suspected, non-invasive examination techniques may give sufficient diagnostic information.

Biopsy↗

PubMedDate not supplied

[Contribution of laparoscopy to the diagnosis of liver involvement by lymphoma. Results in 100 peritoneoscopies (author's transl)].

The retrospective study of 100 peritoneoscopies in cases of hematocarcomas reveals an hepatic involvement in 23% of the patients. The clinical status, the diffusion of the lymph nodes involvement, the radio-isotope scanning and the liver enzymes are not reliable and cannot predict the liver involvement. The peritoneoscopy which allows several and guided biopsies is better than blind transcutaneous liver biopsy.

Biopsy↗

PubMed1981

Peritoneoscopy--use in assessment of intra-abdominal malignancy.

Peritoneoscopy was performed on 236 patients between 1971 and 1980 to assess intraabdominal malignancy or to determine its presence when doubt existed. The diagnostic rate was 86%. The main causes of failure to reach a diagnosis were adhesions arising from previous surgery and tumor adhesions. It was a useful means of obtaining a tissue diagnosis, and the complication rate was low--4.5%. Peritoneoscopy demonstrated the cause of hepatomegaly in 90.9% of patients, the pathology of abdominal masses in 82.5%, and of ascites in 80.5%. It was also useful in assessing abdominal ultrasound and isotope liver scan abnormalities. The procedure is safe, cheap, and allows adequate assessment of intra-abdominal malignancy in a high proportion of patients.

Abdominal Neoplasms↗

PubMed1981

Peritoneoscopy in general surgery.

Peritoneoscopy is a simple and effective means of diagnosing or excluding intra-abdominal disease. It is currently underutilized and merits increased recognition particularly by general surgeons. The first 77 peritoneoscopic examinations performed by a general surgeon in a large hospital associated with a cancer agency are reviewed. An exact diagnosis was made in 78% of 58 patients in whom the primary diagnosis was in doubt and in 93% of that group management was influenced. Surgical exploration of the abdomen was avoided in 29 patients. The major indications for using the method were: to search for metastases, to evaluate the acute abdomen and to stage lymphoma. Local anesthesia and nitrous oxide insufflation were used almost exclusively. Biopsy was performed in 36 patients and there was one death directly attributable to liver biopsy. In two patients peritoneoscopy was unsuccessful.

Abdomen, Acute↗

PubMed1982

Comparison of CO2- and N2O-induced discomfort during peritoneoscopy under local anesthesia.

The most comfortable gas for peritoneoscopy has been the subject of debate. We subjected 46 patients to double-blind comparison of carbon dioxide and nitrous oxide during initial pneumoperitoneum. The discomfort from local anesthesia was similar in both patient groups. The patient's and the physician's assessment of discomfort during gas insufflation showed that carbon dioxide was more uncomfortable as perceived by the patient (p = 0.02), the physician (p = 0.0006), and objectively assessed by degree of abdominal splinting (p = 0.006). The presence of intraabdominal adhesions had no relationship to discomfort. We conclude that nitrous oxide is more comfortable for institution of pneumoperitoneum during peritoneoscopy under local anesthesia.

Adult↗

PubMed1981

[Peritoneoscopy and liver biopsy in the diagnosis of liver disease (author's transl)].

In two prospective studies including 962 patients and one retrospective study including 165 patients the problem was investigated, to what extend ultrasonography might change the diagnostic value of clinical examination, peritoneoscopy, guided liver biopsy and blind liver biopsy. It turned out, that liver biopsy is the method of choice in diffuse-parenchymatous disease (e.g. chronic active hepatitis, chronic persistent hepatitis, fatty liver), whereas laparoscopy is to be preferred if focal lesions (e.g. liver carcinoma) are present. Diffuse liver disease was present in 80% of the cases investigated; in this group of patients the diagnostic value of blind biopsy is equivalent to the diagnostic value of guided biopsy. Thus, blind biopsy does yield satisfactory results in most patients if it is possible to differentiate between diffuse and focal disease by ultrasonography. Such differentiation could be achieved in 77-98% of our cases, thus ultrasonography could intake a decrease in numbers of peritoneoscopies and an increase of blind liver biopsy.

Biopsy, Needle↗

PubMed1978

Peritoneoscopy in the staging of 190 patients with small-cell anaplastic carcinoma of the lung with special reference to subtyping.

Peritoneoscopy with liver biopsy was routinely done as a pretreatment staging procedure in 190 patients with small-cell anaplastic carcinoma of the lung. Subtyping of the patients according to the WHO classification included 28.3% with fusiform cell type (WHO II,1), 28.9% with polygonal cell type (WHO II,2), 41.5% with lymphocytelike cell type (WHO II,3) and 1.3% with mixed types (WHO II, 4). Liver metastases were found in 21% of the patients with adequate liver biopsy. In addition macroscopic signs of liver metastases were observed in 9%. No significant differences were observed among the histological subtypes. Liver function tests, such as alkaline phosphatase, LDH and GOT, were of little value in excluding liver metastases. On the other hand, 2 of 3 abnormal liver function tests were highly indicative of liver metastases. In patients with positive liver biopsy, 41% had liver metastases alone and 76% had no other evidence of distant metastatic disease if bone-marrow involvement identified with bone marrow examination is excluded as a staging procedure.

Adult↗

PubMed1985

Peritoneoscopy in the management of catheter malfunction during continuous ambulatory peritoneal dialysis.

Continuous ambulatory peritoneal dialysis is widely used in the maintenance of patients with chronic renal failure. Obstruction or displacement of the chronic dialysis catheter, which prevents dialysate drainage, can compromise ongoing dialysis. Conservative approaches (body position change, saline infusion, and enema) are often unsuccessful and more aggressive therapy may be required. We report the use of peritoneoscopy to reposition malfunctioning peritoneal dialysis catheters. The procedure proved to be safe and gave excellent long-term results.

Adult↗

PubMed1983

Peritoneoscopy of the liver stained by intravenous injection of indocyanine green-experimental and clinical studies.

Liver surface patterns were observed by peritoneoscopy after intravenous injection of indocyanine green (ICG). The normal rat liver was diffusely stained dark greenish-brown 5 minutes after the injection of ICG 25 mg/kg body weight into the tail vein. Green spots persisted longer in the centrolobular area, clearly revealing lobular markings. This regional difference in hepatocyte staining suggested differing abilities of hepatocytes to take up or excrete ICG. This dyeing technique was applied to liver disease patients. The liver was diffusely stained light greenish-brown 5 minutes after the injection of ICG 5 mg/kg body weight. In patients, especially those with obscure lobular markings before ICG injection, lobules were clearly demarcated by reddish terminal portal veins against a green background. This simplified detection of lobular distortions. Prenodular patches (Kalk's Bunteflecke) on the liver surface were stained green more intensely than surrounding areas, which supports the hypothesis that patches are composed of active hepatocytes.

Adult↗