Cytologic examination as an adjunct to laparoscopy and guided biopsy in the diagnosis of hepatic and gallbladder neoplasia.

Laparoscopic examination guided biopsy and cytologic examination of samples obtained by aspiration, brush or scrape from the liver or gallbladder were performed on 26 patients suspected of having hepatic or gallbladder neoplasia. Laparoscopic findings were diagnostic of hepatic neoplasia (primary or secondary) in 13 cases and gallbladder carcinoma in 9 cases. The yields of positive diagnoses on biopsy alone, cytology alone and combined biopsy and cytology were 11 (84.6%), 11 (84.6%) and 12 (92.3%), respectively, in cases of hepatic neoplasia and 4 (44.4%), 5 (55.5%) and 5 (55.5%), respectively, in cases of gallbladder carcinoma. The cytologic typing concurred with the histologic typing in six of ten cases (60%) of hepatic neoplasia and all four cases (100%) of gallbladder carcinoma. It is suggested that cytologic examination be used as an adjunct to histologic examination of guided biopsies in the diagnosis of hepatic neoplasia. It is also concluded that it is possible to make a tissue diagnosis in patients with gallbladder carcinoma by obtaining material for cytology and biopsy through laparoscopy.