I. Med Department, Johannes Gutenberg University of Mainz, Mainz, Germany.
Curr Opin Gastroenterol. 2012 Sep;28(5):461-6. doi: 10.1097/MOG.0b013e3283561f25.
The evaluation of liver histology is an important component of the diagnosis and staging of liver diseases. The most common technique employed to sample liver tissue for decades has been percutaneous liver biopsy. Although this is a relatively well tolerated technique in the early stages of liver disease, it carries a high risk of complications, particularly hemorrhage, in patients with advanced cirrhosis. Mini-laparoscopy allows macroscopic assessment and biopsy under direct vision and therefore is a well tolerated and effective technique.
The major advantages of this technique are direct visualization of the liver surface, thereby allowing inspection for morphologic changes of cirrhosis as well as targeted biopsies, the ability to immediately treat potential complications (bleeding and bile leakage), furthermore the peritoneal cavity can be visualized to stage gastrointestinal (GI) malignancies. Additionally, 'blind' percutaneous liver biopsy fails to establish a diagnosis in about 25% of cases, largely because of sampling error.
This technique presents the opportunity to visualize the surface of the liver and the peritoneal cavity, making it a valuable tool for liver biopsy. This review summarizes the technique of mini-laparoscopy and addresses its potential uses and limitations as a diagnostic modality.
肝脏组织学评估是肝脏疾病诊断和分期的重要组成部分。几十年来，用于采集肝脏组织样本的最常用技术是经皮肝活检。虽然在肝脏疾病的早期阶段，这种技术相对耐受良好，但在晚期肝硬化患者中，它有很高的出血等并发症风险。迷你腹腔镜检查可在直视下进行宏观评估和活检，因此是一种耐受良好且有效的技术。
该技术的主要优点是可以直接观察肝脏表面，从而可以检查肝硬化的形态变化并进行靶向活检，能够立即治疗潜在的并发症（出血和胆汁渗漏），此外还可以观察腹膜腔以分期胃肠道（GI）恶性肿瘤。此外，约 25%的“盲目”经皮肝活检未能确立诊断，主要是由于采样误差。
该技术提供了观察肝脏表面和腹膜腔的机会，使其成为肝活检的有价值工具。本综述总结了迷你腹腔镜检查技术，并讨论了其作为诊断方式的潜在用途和局限性。
