在因腹腔内癌肿而进行削腹术时,肝脏内转移十分常见。Ozley 等曾报道640例大肠癌手术病例,其中112例(18%)在术时扪诊可发现肝脏已有转移。肝脏的转移对预后具有明显的影响,而且直接影响外科医生对病人的处理。目前肝脏显象技术越来越精确,这些方法包括超声检查、计算机 X 线断层摄影,应用放射性物质行扫描术和动脉造影术,但仍有假阳性和假阴性的结果。假阴性结果最常见的原因是病灶过小,难以见到。假阳性发现可能由于肝脏的良性局限性病灶所致。尽管在手术前的各种先进的检查均为阴性,但仍可发现肝内有转移。而术前预测预后最差的病人,术时所见与所预测的情况也可不一致。40年前,Goligher 分析893例直肠癌行剖腹术的病例,发现其中103例(12%)有肝脏转移,31例于术时肝脏光滑且摸不到转移肿块,但在术后立即死亡,尸解发现其中5例在肝脏深部有继发性肿瘤。Hogg 等研究因各种腹腔内肿瘤行剖腹术而在剖腹术后30天内死亡 Intra-abdominal metastases are very common when abdomen surgery is performed for intra-abdominal cancer. Ozley et al. have reported 640 cases of colorectal cancer surgery, of which 112 cases (18%) were diagnosed at the time of surgery and found that the liver had metastasized. Liver metastasis has a significant impact on prognosis and directly affects the surgeon’s treatment of the patient. Current liver imaging techniques are becoming more and more accurate. These methods include ultrasonography, computerized tomography, radiological line scans, and arteriography, but there are still false-positive and false-negative results. The most common cause of false negative results is that the lesion is too small to be seen. False positive findings may be due to the benign limitations of the liver. Although various advanced tests before surgery were negative, liver metastases could still be found. In patients with the worst prognosis before surgery, the results seen and predicted at the time of surgery may not be the same. Forty years ago, Goligher analyzed 893 cases of rectal cancer undergoing laparotomy and found that 103 of them (12%) had liver metastases. In 31 cases, the liver was smooth and had no metastatic mass at the time of surgery, but died immediately after surgery. Findings revealed that 5 of them had secondary tumors deep in the liver. Hogg et al.’s study died of laparotomy for various intra-abdominal tumors and died within 30 days after laparotomy