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ACTA Endoscopica

0240-642X
Revue officielle de la Société Française d'Endoscopie Digestive
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 ARTICLE VOL 19/1 - 1989  - pp.1-9  - doi:10.1007/BF02978329
TITRE
Es util la laparoscopia en el control de la hepatitis cronica

TITLE
Is laparoscopy useful in the follow-up of chronic hepatitis?

RÉSUMÉ

Los autores han intentado comprobar si las modificaciones macroscópicas de la superficie hepática vistas en el curso de la laparoscopia tienen valor predictive en la valoración del curso evolutivo de la hepatitis crónica. Se practicó una laparoscopia con biopsia hepática a cuarenta y tres pacientes afectos de hepatopatía crónica. Las laparoscopias-biopsias de control se hicieron en un periodo que osciló entre 8 y 45 meses.

En la serie estudiada 6 pacientes se hallaban afectos de hepatitis crónica persistente (HCP), 9 de hepatitia crónica activa (HCA) y 28 de cirrosis (HCA-C). En el conjunto de pacientes no hubo variación de la histología en 17 casos (6 NCP, 2 HCA, 9 HCA-C). En el periodo de seguimiento se controlaron las modificaciones laparoscópicas en 19 pacientes más.



ABSTRACT

The authors investigated whether the macroscopic changes of liver surface observed at laparoscopy may further define the progressive course of chronic hepatitis. Forty-three patients with chronic liver disease underwent laparoscopy and guided liver biopsy. Control laparoscopy-biopsy was performed over an 8–45 month-period.

Six patients had chronic persistent hepatitis (CPH), 9 chronic active hepatitis and 28 with cirrhosis + Of these, histology was unchanged in 17 (6 CPH, 2 9 + During the follow-up, macroscopic changes were observed in another 19 patients. In 4 patients with the hepatic surface became granular, with histology showing no modifications in 2, increased activity in one and decreased activity in the fourth case. Ten patients with + developed macroscopic signs of portal hypertension and the histological activity was improved in all. Another 5 patients with + showed a diffuse or zonal nodular liver surface on laparoscopy; histology was unchanged in 2 and improved in 3. Finally, in one patient with the liver surface, which was finely granular at the first laparoscopy, became smooth in the following 28 months, while the histological activity did not change. This follow-up study shows that: i) CPH is a benign, non progressive disease, while is a fluctuating illness which frequently evolves in cirrhosis; ii) laparoscopy gives complementary informations (lymphatic microcysts, ascites, splenomegaly) which lead to a better definition of the evolution of the chronic liver disease.



AUTEUR(S)
R. ORLANDO, F. LIRUSSI, L. OKOLICSANYI

MOTS-CLÉS
biopsía hepática, hepatitis cronica, laparoscopia

KEYWORDS
chronic hepatitis, laparoscopy, liver biopsy

LANGUE DE L'ARTICLE
Français

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