肝炎及び肝硬変の病態生理に関する腹腔鏡学的研究

第一編 肝硬変症における肝表面構造と内部組織との関連性について

抄録

The purpose of this study is to investigate the diagnostic value of needle liver biopsy, to compare microscopic histological and gross macroscopic findings of the cirr-hotic liver, and to attempt to classify cirrhosis from clinical point of view. 40 cases with cirrhosis were selected in this study. A peritoneoscope with gradation and also a probe with gradation were utilized.
No significant differences in size of nodules, superficial and noted in the autopsied cases. Accurate diagnosis of cirrhosis by means of needle biopsy technique was app-roximately 70 to 85%, the larger the nodules, the lower the accuracy. 15% of difference in the diagnostic accuracy was observed when two kinds of biopsy needles, 2.0mm and 1.5mm in diameter, were used.
Inflammatory or active process, proliferated connective tissue or necrotic areas and sublobular pseudolobules were frepuently observed in those cirrhotic livers with smaller nodules. Multilobular pseudolobules were seen rather in the cirrhotic livers with larger nodules. Clinical courses in cirrhotic patients with larger nodules were longer as compared with those with smaller ones. Such cases were frequently seen in whom the nodules grew larger with the passage of time.
Although it was considered to be rather difficult to establish accurate diagnosis of cirrhosis only by means of needle liver biopsy technique, it would be possible when peritoneoscopy and further measurement were undertaken.