Tanaka Naoki, Ichijo Tetsuya, Okiyama Wataru, Mutou Hidetomo, Misawa Noriko, Matsumoto Akihiro, Yoshizawa Kaname, Tanaka Eiji, Kiyosawa Kendo
Division of Gastroenterology, Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Liver Int. 2006 Feb;26(1):32-8. doi: 10.1111/j.1478-3231.2005.01198.x.
BACKGROUND/AIMS: Laparoscopic observation of the liver is important to diagnose liver conditions accurately. However, the laparoscopic findings of nonalcoholic steatohepatitis (NASH) have not been characterized. The aim of this study was to clarify the laparoscopic characteristics of NASH.
Twenty-four patients were enrolled. The degrees of hepatomegaly, color and irregularity of the liver surface, and the presence of depressions, patches, and vesicles were investigated. These laparoscopic findings were compared among NASH, alcoholic liver disease (ALD), and autoimmune hepatitis (AIH).
Mild hepatomegaly, dullness of the liver edge, increased fat accumulation of the round ligament, and whitish markings were found in most of the patients with NASH. Small depressions were observed in approximately 70% of the patients. As fibrosis developed, the liver surface became whiter and more uneven. Compared with patients with ALD and AIH, increased fat accumulation of the round ligament and dullness of the liver edge were observed more frequently in those with NASH. However, coarse and groove-like depressions were rare in NASH patients.
Several findings, including mild hepatomegaly, increased fat accumulation of the round ligament, rounded liver edge, whitish markings, and small depressions were common in patients with NASH. However, coarse and groove-like depressions were rare. These findings may be helpful for confirming a diagnosis of NASH.
背景/目的：腹腔镜观察肝脏对于准确诊断肝脏疾病很重要。然而，非酒精性脂肪性肝炎（NASH）的腹腔镜检查结果尚未得到明确描述。本研究的目的是阐明NASH的腹腔镜特征。
纳入24例患者。研究肝脏肿大程度、肝脏表面颜色及不规则情况，以及凹陷、斑块和水疱的存在情况。对NASH、酒精性肝病（ALD）和自身免疫性肝炎（AIH）患者的这些腹腔镜检查结果进行比较。
大多数NASH患者存在轻度肝脏肿大、肝边缘钝圆、圆韧带脂肪堆积增加及白色斑纹。约70%的患者观察到小凹陷。随着纤维化发展，肝脏表面变得更白且更不平整。与ALD和AIH患者相比，NASH患者圆韧带脂肪堆积增加和肝边缘钝圆更为常见。然而，NASH患者中粗大和沟状凹陷很少见。
包括轻度肝脏肿大、圆韧带脂肪堆积增加、肝边缘圆钝、白色斑纹和小凹陷等多项表现，在NASH患者中很常见。然而，粗大和沟状凹陷很少见。这些表现可能有助于NASH的确诊。
