Abstract
Comparative studies were made on laparoscopic features of the liver surface and concentration of stainable copper granules in liver biopsy specimens of untreated patients with Wilson's disease. Nine cases (eight males and one female) including cases of the two siblings were studied. According to the uneveness and coloration of the liver surface, laparoscopic findings were classified into four types as follows, type I : smooth surface with yellowish brown coloration, type II: granular surface with whitish brown coloration, type III: nodular surface with dark brown or dark purple-blue coloration, and type IV : hemispherical nodular formation with dark purple-blue coloration. On the basis of our classification, it may be suggested that the nodular formation of the liver in Wilson's disease coincides with advance of dark coloration. Copper granules stained by Rhodanine in biopsy specimens were estimated by their size and distribution. As dark colorations and nodular formation of the liver surface advanced, concentration of stainable copper granules increased. We propose that laparoscopic findings of the liver surface in untreated Wilson's disease play an important role in the advancement of Wilson's disease.
