Sakurai M, Okamura J, Kuroda C, Yamada T
Jpn J Surg. 1986 Nov;16(6):398-405. doi: 10.1007/BF02470606.
Histopathology of cirrhosis was compared to the hepatic functional reserve and to the prognosis. One hundred and thirteen patients including 51 surgically treated for hepatocellular carcinoma (HCC) and 62 subjected to wedge biopsy of the liver during surgery for esophageal varices were studied. The type of cirrhosis associated with hepatocellular carcinoma was classified into 4 groups according to the degree of inflammation and the piecemeal necrosis. Of the 16 without cirrhosis, 13 (81 per cent) are living. Nine had an inactive cirrhosis and 5 (56 per cent) are living. Ten had a slightly active cirrhosis and 4 (40 per cent) are living. Sixteen had a fairly active cirrhosis and 7 (44 per cent) are alive. Immediate postoperative death due to acute hepatic failure occurred in 6, 4 of whom had a fairly active cirrhosis. In patients with active alcoholic hepatitis with numerous Mallory bodies and ballooning degeneration of liver cells, the prognosis was the poorest, if the liver was resected, even though the functional reserve seemed to be adequate. To prevent acute hepatic failure, liver histology during the surgery is predictive and wedge biopsy of the liver is recommended.
对肝硬化的组织病理学与肝功能储备及预后进行了比较。研究了113例患者，其中51例因肝细胞癌（HCC）接受手术治疗，62例在食管静脉曲张手术期间接受肝脏楔形活检。根据炎症程度和桥接坏死，将与肝细胞癌相关的肝硬化类型分为4组。16例无肝硬化患者中，13例（81%）存活。9例为静止性肝硬化，5例（56%）存活。10例为轻度活动性肝硬化，4例（40%）存活。16例为相当活动性肝硬化，7例（44%）存活。6例因急性肝衰竭术后即刻死亡，其中4例有相当活动性肝硬化。在有大量马洛里小体和肝细胞气球样变的活动性酒精性肝炎患者中，如果进行肝脏切除，即使肝功能储备似乎充足，预后也是最差的。为预防急性肝衰竭，手术期间的肝脏组织学具有预测性，建议进行肝脏楔形活检。
