[摘要翻译]肝硬化诊断:标准腹腔镜,微创腹腔镜和组织学对比研究

文题：The diagnosis of liver cirrhosis: a comparative evaluation of standard laparoscopy, mini-laparoscopy and histology
作者：Weickert U, Siegel E, Schilling D, Eickhoff A, Jakobs R, Bohrer MH
杂志全名： Z Gastroenterol
年份，卷（期）: 起止页码：2005 Jan;43(1):17-21
PMID： 15650967
英文摘要：BACKGROUND: The superiority of laparoscopy with guided biopsy over biopsy alone is established. It is still uncertain if this is also true for midi-/ and mini-laparoscopy. AIM: The aim of this study was to determine the diagnostic gain of laparoscopic-guided biopsy for standard laparoscopy and the use of midi-/mini-laparoscopies. Characteristics of the liver biopsies were investigated with regard to a missed diagnosis of cirrhosis. METHODS: In a consecutive series of 425 patients clinical, laparoscopic and histological findings were investigated. The length and fragmentation of the liver biopsies were investigated with regard to a missed diagnosis of cirrhosis. RESULTS: The sensitivity of laparoscopy in the diagnosis of cirrhosis was 96 %, that of histology 68 %. The sensitivity of histology alone was especially low in macronodular cirrhosis. The sensitivity of both laparoscopy and histology improved from Child A to C. When cirrhosis was apparent, liver biopsies were shorter and more frequently fragmented. However, the diagnosis of cirrhosis was independent of these parameters. CONCLUSION: Mini-laparoscopy may replace standard laparoscopy and appears to be superior compared with histology alone.
中文译文：
背景:伴有组织学检查的腹腔镜检查的优越性较单一组织学检查明显.对于微创腹腔镜来说是否也是这样的呢?优待于进一步考证.
目的:这项研究的目的在于探讨腹腔镜引导 的组织学检查与微创腹腔镜检查的诊断价值.就肝硬化的漏诊率而言,肝组织学检查的特性也作为调查的对象.
方法:在连续的425例临床患者中,腹腔镜检查和组织学检查患者作为被调查的对象.就肝硬化的漏诊而言,肝组织的活检的组织长度和断裂也被调查了.
结果:在肝硬化的诊断中,腹腔镜检查的灵敏性为96 %,肝组织检查的灵敏性为68 %,组织学单独检查在巨结性肝硬化中的灵敏度更低.在Child A to到C.患者中,两者结合灵敏度显著改善,当肝硬化明显时,肝组织检查与前比缩短,但有更多的断片.然而,肝硬化的诊断不依赖于这些参数的.
结论:微创腹腔镜可取代标准的腹腔镜,与单独组织学检查比较显示了良好的优越性.
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