Diagnostic laparoscopy: a 5-year experience in a hepatology training program

Vargas, Carlos; Jeffers, L; Bernstein, David; Reddy, K. Rajender; Munnangi, Swapna; Behar, Sol; Scott, Christopher D.; Parker, Talley; Schiff, E.

doi:10.1097/00042737-199512000-00020

Cited by 25 publications

(29 citation statements)

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“…The laparoscope is of great value for precise identification of liver pathology [17]. Whereas cirrhosis and malignancy constituted the major cause of hepatomegaly in our series, an appreciable number of hepatomegalies were caused by abscesses, hydatid cysts, Riedl's lobe, polycystic disease, tuberculoma, and diffuse hepatomegaly.…”

Section: And the Livermentioning

confidence: 55%

“…Vargas et al [17], in a summary of 1,794 cases over a 5-year period, found that DL gave a correct diagnosis in 98% of chronic liver disease cases, 91% of persistently abnormal liver function test cases, and 85% of primary or secondary liver malignancy cases. Stahel et al [9], working in rural Tanzania, found that only clinical examination concurred with the final diagnosis in 40% of cases, clinical and laboratory investigation in 46% of cases, and the addition of DL without biopsy in 71% of cases, whereas laparoscopy with biopsy yielded positive results in more than 90% of cases.…”

Section: And the Livermentioning

confidence: 99%

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Diagnostic laparoscopy

Udwadia

2004

Surgical Endoscopy

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Diagnostic laparoscopy began in a surgical unit in a developing country in 1972. The developers of this technique aimed to hasten diagnosis, reduce patient distress, and improve bed utilization in an overcrowded teaching hospital wherein simple investigations such as x-rays took weeks to materialize. Over a period of 18 years reaching to 1990, 3,200 diagnostic laparoscopies were performed on adults under local anesthesia with no mortality, a complication rate of 0.09%, an 84% diagnosis rate, and 74% undergoing histologic biopsies targeting a wide spectrum of pathology. The equipment cost spread out over the 3,200 patients works out to 30 rupees (0.60 dollar) per patient. With the availability of noninvasive diagnostic aids such as ultrasound, computed tomography, and magnetic resonance imaging used US, CT, MRI under the control of target biopsy, the role of diagnostic laparoscopy has altered. Since 1990, clinicians have had the sophistication of the video camera and the pneumoperitoneum insufflator. Diagnostic laparoscopy is used for the evaluation of liver and peritoneal pathology, abdominal tuberculosis, malignancy, acute abdomen, and abdominal trauma. It often is a prelude to laparoscopic treatment of the underlying pathology, specifically in cases of acute appendicitis.

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Section: And the Livermentioning

confidence: 55%

Section: And the Livermentioning

confidence: 99%

Diagnostic laparoscopy

Udwadia

2004

Surgical Endoscopy

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“…In one large study of 1794 patients, laparoscopic liver biopsies performed in a hepatology training programme provided definitive diagnoses of chronic liver disease in 98% of patients with a rate of only 0.45% major complications. 6 Because a liver biopsy samples only about 1/50 000th of the entire liver, it may not be representative. Sampling error can approach 20-30%.…”

Section: Introductionmentioning

confidence: 99%

The evolving role of liver biopsy

Campbell

Reddy

2004

Aliment Pharmacol Ther

111

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Summary Liver biopsy is traditionally the ‘gold standard‘ for the evaluation of liver diseases. There are several situations in which its role is being challenged. In hepatitis C, liver biopsy helps assess prognosis and treatment candidacy. An important exception is genotype 2 or 3 because treatment is more likely to succeed and therapy is relatively short in duration. For hepatitis B, liver biopsy gives some prognostic information, but serologic tests and hepatic biochemical tests are the primary determinants of treatment candidacy. Non‐alcoholic fatty liver disease can be accurately diagnosed without a liver biopsy and, furthermore, there are no specific therapies available. The role of liver biopsy to assess methotrexate‐associated hepatotoxicity remains controversial. Finally, patients with focal liver lesions usually do not require biopsy and, in the case of hepatocellular carcinoma, biopsy carries a risk of needle‐track seeding. In short, the need for liver biopsy depends on the specific situation and should be performed when there is sufficient uncertainty about diagnosis, severity of disease, prognosis, and treatment decisions.

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“…(42) The complications of laparoscopic liver biopsy include vasovagal reaction, seizure, abdominal wall hematoma, abdominal viscus perforation, hemobilia, splenic laceration, bleeding and prolonged abdominal pain. (45) …”

Section: Laparoscopic Liver Biopsymentioning

confidence: 99%

Complications of Liver Biopsy

Alghamdi¹

2011

Liver Biopsy

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Diagnostic laparoscopy: a 5-year experience in a hepatology training program

Cited by 25 publications

References 0 publications

Diagnostic laparoscopy

Diagnostic laparoscopy

The evolving role of liver biopsy

Complications of Liver Biopsy

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