What is a diagnostic laparoscopy for liver cancer biopsy?

A diagnostic laparoscopy for liver cancer biopsy is a procedure in which the doctor uses a laparoscope (a thin tube with a light) to look at your liver and take samples of any unusual cells found.

When is it used?

You may have had a liver biopsy that suggested something is wrong with your liver. Your doctor may suspect it is cancer. Your doctor may use this procedure to learn more about your liver problem.

Examples of alternatives are:

• trying other procedures, such as abdominal surgery

• having an ultrasound; a scan with high-frequency sound waves

• having a CT scan of the abdomen with or without a needle biopsy

• choosing not to have treatment, while recognizing the risks of your condition.

However, imaging procedures, such as ultrasound or a CT scan, may not be a substitute for tissue diagnosis. Ask your doctor about these choices.

How do I prepare for a diagnostic laparoscopy?

Plan for your care and recovery after the operation. Allow for time to rest and try to find other people to help you with your day-to-day duties.

Follow instructions provided by your doctor. Eat a light meal, such as soup or salad, the night before the procedure. Do not eat or drink anything after midnight and the morning before the procedure. Do not even drink coffee, tea, or water.

What happens during the procedure?

A general anesthetic is given, which relaxes your muscles, makes you feel as if you are in a deep sleep, and prevents you from feeling pain.

Your peritoneal cavity is inflated with carbon dioxide gas. This expands your peritoneal cavity like a balloon and helps the doctor see your liver. The doctor makes a small cut near your belly button, puts in the gas, puts a laparoscope into the abdominal cavity, and puts another tool through a small cut in the abdomen. The doctor guides the scope to look at your liver. If the doctor finds a growth that should not be there, he or she may use the other tool to take a sample of the growth. The sample is sent to the laboratory for analysis.

What happens after the procedure?

You may stay in the hospital for a few hours or overnight. The anesthetic may cause sleepiness or grogginess for a while. You may have some shoulder pain, feel bloated, or find a change in bowel habits for a few days. You may not be able to urinate right away and may have a catheter (a small tube) placed into your bladder through the urethra (the tube from the bladder to the outside) for a few days.

You should avoid heavy activity such as lifting. You should ask your doctor how much you should lift, what other steps you should take, and when you should come back for a checkup.

What are the benefits of this procedure?

This surgical procedure may help the doctor make a more accurate diagnosis and tell if you have cancer in your liver.

What are the risks associated with this procedure?

• There are some risks when you have general anesthesia. Discuss these risks with your doctor.

• The abdominal organs, glands, intestines, or blood vessels may be damaged. The doctor may perform abdominal surgery to repair them at the time of the procedure.

• The lining of the abdominal cavity may become inflamed.

• A blood clot may break off, enter the bloodstream, and clog an artery in your lungs, pelvis, or legs. Rarely, a clot may break off and clog an artery in the heart or brain, causing a heart attack or stroke.

• You may develop an infection or bleeding.

• There may be some pain after the procedure.

You should ask your doctor how these risks apply to you.

When should I call the doctor?

Call the doctor immediately if:

• You develop a fever.

• You develop redness, swelling, pain, or drainage from the small incisions.

• You become dizzy and faint.

• You develop nausea and vomiting.

• You become short of breath.

• You have abdominal pain or swelling that gets worse.

Call the doctor during office hours if:

• You have questions about the procedure or its result.

• You want to make another appointment.