Eggert A, Becker J, Kopf R, Hartmann V
Leber Magen Darm. 1984 May;14(3):97-101.
Biopsy of the liver with the menghini needle was done as a routine diagnostic procedure during surgery in 581 cases. During earlier decades morphological changes of the liver could be demonstrated by that procedure in 80-100% of the patients. In contrast such changes could be found only in 55% of our cases; in 5,5% these changes were severe. From these numbers it should be concluded that liver biopsy during gall bladder surgery is not necessary as a routine procedure. If patients are selected for biopsy on the basis of history, ultrasonography, laboratory data and intraoperative microscopical liver findings this procedure is necessary only in 14% of the cases, complication rate being 0,09%. In this particularly selected group changes of the liver can be found in 90,4%, severe changes in 33% of the cases. Pathological changes of the liver are likely to occur in 65-91% of patients with complicated gall stone disease and/or accompanying diseases like diabetes, obesitas, alcoholism, or a history of hepatitis. In this particular group biopsy and histological examination during surgery seem to be indicated as it was the case before.
在581例手术过程中，采用Menghini针进行肝脏活检作为常规诊断程序。在过去几十年里，通过该程序可在80%至100%的患者中发现肝脏的形态学变化。相比之下，在我们的病例中，仅55%能发现此类变化；其中5.5%的变化较为严重。从这些数据可以得出结论，胆囊手术期间的肝脏活检作为常规程序并非必要。如果根据病史、超声检查、实验室数据和术中肝脏微观检查结果选择患者进行活检，该程序仅在14%的病例中是必要的，并发症发生率为0.09%。在这个特别挑选的组中，90.4%可发现肝脏变化，33%有严重变化。在患有复杂胆结石疾病和/或伴有糖尿病、肥胖症、酒精中毒或肝炎病史等伴随疾病的患者中，肝脏病理变化可能发生在65%至91%。在这个特定组中，手术期间的活检和组织学检查似乎如之前那样是必要的。
