Orlando R, Lirussi F, Okolicsanyi L
Institute of Internal Medicine, University of Padua, Italy.
J Clin Gastroenterol. 1990 Feb;12(1):47-52.
We examined retrospectively 1,003 patients with chronic liver disease who underwent laparoscopy and liver biopsy. The diagnosis of cirrhosis was made in 411 patients and excluded in 570; in the remaining 22 patients, the laparoscopic/histologic diagnosis was inconclusive. When the two techniques were considered separately, a final diagnosis of cirrhosis was possible in 78.4% by laparoscopy and in 78.8% by biopsy of the total of 411 cases, whereas, doing both procedures improved the diagnostic yield to 97.7% by decreasing the percentage of false negatives for each technique. Laparoscopy can also provide important additional information by detecting intrabdominal signs of portal hypertension and so improve the macroscopic diagnosis of cirrhosis. In particular, splenomegaly seen at laparoscopy seems to be an important feature for the diagnosis and evaluation of chronic liver disease.
我们回顾性研究了1003例接受腹腔镜检查和肝活检的慢性肝病患者。411例患者被诊断为肝硬化，570例被排除；其余22例患者的腹腔镜/组织学诊断不明确。当分别考虑这两种技术时，在总共411例病例中，腹腔镜检查最终诊断肝硬化的可能性为78.4%，活检为78.8%，而同时进行这两种检查可通过降低每种技术的假阴性率将诊断率提高到97.7%。腹腔镜检查还可通过检测门静脉高压的腹内体征提供重要的额外信息，从而改善肝硬化的宏观诊断。特别是，腹腔镜检查发现的脾肿大似乎是慢性肝病诊断和评估的一个重要特征。
