Evaluation of Cirrhosis by Laparoscopy : Clinical and Histopathological Observations of One Hundred Cases of Nodular Liver

概要

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In order to determine clinical characteristics of hepatic cirrhosis, one hundred cases of nodular liver which was confirmed by laparoscopic examinations were reviewed. Men predominated over women in a ratio of 2 : 1, and a relatively high incidence in young men was noted. The importance of hepatitis virus in the pathogenesis of cirrhosis was confirmed in view of the history of acute hepatitis and positive HBsAg or anti-HBs. Ninety four of the 100 patients showed physical findings suggestive of cirrhosis, and cirrhosis was suspected in 95 cases prior to laparoscopic examination. These results again emphasized the importance of accurate clinical assessments. In the remaining five patients, however, careful clinical evaluation as well as histopathologic findings without laparoscopy failed to determine the final diagnosis of cirrhosis. It was of note that four of them were young males, and three had persistently positive HBsAg. Using guided liver biopsy, diagnosis of cirrhosis was confirmed histologically in 60 patients, but in the remaining 40 patients the diagnosis of cirrhosis might not have been obtained without laparoscopy. No major complication was noted in our series of 100 examinations. Based on the result of our present study, laparoscopic examination is considered safe, and the most reliable procedure in establishing the diagnosis of cirrhosis.
東海大学の論文