The role of laparoscopy in the diagnosis of cirrhosis

Poníachik, Jaime; Bernstein, David; Reddy, K. Rajender; Jeffers, Lennox J.; Coelholittle, M; Civantos, Francisco; Schiff, Eugene R.

doi:10.1016/s0016-5107(96)70192-x

Cited by 198 publications

(104 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In contrast, mini laparoscopy (ML) in conjunction with laparoscopic guided liver biopsy combines the visual inspection of the liver surface with histological evaluation of the liver, rendering it an attractive approach in ALF. The macroscopic appearance of liver parenchyma provides valuable additional information to histological examination alone, and ML appears equivalent to surgical laparoscopy for this purpose [13,14]. Additionally, ML has been deemed safe in multiple case series, among patients with or without coagulopathy [15,16].…”

Section: Introductionmentioning

confidence: 99%

Mini-Laparoscopy Guided Liver Biopsy Increases Diagnostic Accuracy in Acute Liver Failure

Dechêne¹,

Sowa²,

Schlattjan³

et al. 2014

Digestion

View full text Add to dashboard Cite

Background/Aims: For diagnosis, prognosis, and treatment of acute liver failure (ALF), macroscopic evaluation and histological assessment of the liver are important. Due to impaired coagulation in ALF, the risk of bleeding is high after a percutaneous liver biopsy. Our aims were to assess (i) safety and benefit of mini laparoscopy (ML) in patients with ALF and (ii) the potential utility of histological markers in ALF prognosis. Methods: ML was performed in 39 patients with ALF to assess liver surface and to obtain a liver biopsy. Serological markers of liver injury and immunohistochemical detection of cell death and proliferation were compared to a non-ALF group (n = 10). Results: Liver biopsies were successfully performed in all patients with no significant complications. All patients had markedly elevated M30 and M65 levels in the serum. In the liver, M30 and Ki67 immune-reactive cells were more abundant in those with ALF. Importantly, there were significantly more Ki67-positive cells but fewer M30-positive cells in livers of ALF patients who recovered spontaneously. Conclusion: ML with liver biopsy in patients with ALF and severe coagulopathy is safe. Immunohistochemical detection of liver cell death and regeneration may identify individuals who would recover spontaneously or who would need a liver transplant.

show abstract

Section: Introductionmentioning

confidence: 99%

Mini-Laparoscopy Guided Liver Biopsy Increases Diagnostic Accuracy in Acute Liver Failure

Dechêne¹,

Sowa²,

Schlattjan³

et al. 2014

Digestion

View full text Add to dashboard Cite

show abstract

“…Histological assessment of fibrosis is also an inherently subjective process and is subject to sampling variability. A study that compared laparoscopic versus histological diagnosis of cirrhosis found that 32% of cases were underdiagnosed with histological examination of a single liver biopsy specimen [17]. And a number of studies have demonstrated that excessive rates of sampling error (25-40%) result in poor reproducibility regardless of the underlying liver disease origin [18].…”

Section: Introductionmentioning

confidence: 99%

MR T1ρ as an imaging biomarker for monitoring liver injury progression and regression: an experimental study in rats with carbon tetrachloride intoxication

et al. 2012

View full text Add to dashboard Cite

show abstract

“…This sample error of liver biopsy has been described in 17-32% of cases in many previous examinations matching macro- and microscopic findings in chronic liver disease [5,13,14,15], including randomized trials that compared laparoscopy and mini-laparoscopy with percutaneous liver biopsy [6,16]. Histologic understaging of the liver disease seems to be more frequent in early (Child A) and macronodular cirrhosis [17] and is clearly dependent on the quality of the biopsy cylinder [18,19].…”

Section: Discussionmentioning

confidence: 88%

“…Due to the fact that inflammatory activity and fibrosis in chronic liver disease are heterogeneously distributed throughout liver tissue, histologic evaluation alone may cause a relevant sample error [5,6]. …”

Section: Introductionmentioning

confidence: 99%

Mini-Laparoscopy Is Superior in Detecting Liver Cirrhosis and Metastases in Liver Cancer: An Over 10-Year Experience in 1,788 Cases

Hilgard¹,

Dechêne²,

Canbay³

et al. 2014

Digestion

View full text Add to dashboard Cite

Background/Aims: Mini-laparoscopy has, since its first description in 1998, proven to be a valuable diagnostic method in liver diseases. We re-evaluated the significance of mini-laparoscopy for diagnosis and staging of liver disease and primary liver and bile duct cancer. Patients and Methods: 1,788 consecutive patients who received a diagnostic mini-laparoscopy between 10/1998 and 06/2011 were included in this retrospective cohort study. Results: In chronic liver disease, cirrhosis was detected by mini-laparoscopy in 27% of cases. A comparison of microscopic versus macroscopic diagnosis of cirrhosis revealed a sampling error for histology alone of 21%. Macroscopic inspection of the liver surface contributed to the diagnosis of unknown liver diseases in approximately 38%. In patients with bile duct or liver cancer, mini-laparoscopy led to upstaging of the disease in 33 and 23%, respectively. Major complications (bowel perforation and delayed bleeding) occurred in 0.39% of cases. Conclusions: Mini-laparoscopy is a valuable procedure with significant diagnostic impact in known and unknown inflammatory and malignant liver diseases. It can be safely performed even in patients with acute liver failure and severe coagulopathy and the diagnostic value does not differ from diagnostic laparoscopy performed with standard instruments.

show abstract

The role of laparoscopy in the diagnosis of cirrhosis

Cited by 198 publications

References 15 publications

Mini-Laparoscopy Guided Liver Biopsy Increases Diagnostic Accuracy in Acute Liver Failure

Mini-Laparoscopy Guided Liver Biopsy Increases Diagnostic Accuracy in Acute Liver Failure

MR T1ρ as an imaging biomarker for monitoring liver injury progression and regression: an experimental study in rats with carbon tetrachloride intoxication

Mini-Laparoscopy Is Superior in Detecting Liver Cirrhosis and Metastases in Liver Cancer: An Over 10-Year Experience in 1,788 Cases

Contact Info

Product

Resources

About