LAPAROSCOPIC CHANGES IN PATIENTS WITH CHRONIC ACTIVE HEPATITIS IN WHOM HISTOLOGIC PROGRESSI ONWAS REVEALED IN A SHORT PERIED

Abstract

In order to evaluate the relationship between laparoscopic features and histological findings of the liver in patients with chronic active hepatitis in whom hepatic disorders progressed in a short period, the changes of liver surface were evaluated in patients whose findings of liver histologi were aggravated at repeated examination. Subjects were 16 patients with chronic active hepatitis, of whom 10 had repeated liver biopsies under laparoscopy, and the remaining six had both blind biopsy and biopsy under direct view through laparoscopy. The mean follow-up period from the 1st to 2nd examination was 20 months. In addition to the macroscopical changes, such as irregularity and nodular formation on the liver surface, fine laparoscopic observations also gave us more reliable markers which suggested possible progression of tissue damage. These markers were that is increased numbers of small vessels, star and/or mesh like reddish marking, reddish patchy marking and many small depressions. Moreover, nodules were visualized sporadically, in the early stage of nodular liver of B type viral chronic heatitis. Therefore, it might be possible to predict laparoscopically the progression of chronic acitive hepatitis, if the appearance of these markers is revealed on the liver surface through the clinical course.