Prospective Randomized Comparison of Minilaparoscopy and Percutaneous Liver Biop

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J Clin Gastroenterol. 2007 Jan;41(1):103-110.

Prospective Randomized Comparison of Minilaparoscopy and Percutaneous Liver

Biopsy: Diagnosis of Cirrhosis and Complications.

Denzer U, Arnoldy A, Kanzler S, Galle PR, Dienes HP, Lohse AW.

*I Medical Department Johannes Gutenberg University Mainz, Mainz daggerI

Medical Department, University Medical Center Hamburg Eppendorf, Hamburg

double daggerInstitution for Pathology, University Medical Center Koln,

Koeln, Germany.

BACKGROUND AND AIMS: Liver cirrhosis represents an advanced stage of hepatic

fibrosis characterized by distortion of organ architecture and formation of

regenerative nodules. Retrospective series reported percutaneous liver

biopsy to miss cirrhosis in about 30%. The aim of this study was to

prospectively compare diagnostic sensitivity regarding the detection of

cirrhosis and the complication rates of percutaneous versus minilaparoscopic

liver biopsy in chronic liver disease. METHODS: Eight hundred fifty-seven

patients were randomized to percutaneous (415) or to minilaparoscopic liver

biopsy (442). Macroscopic liver evaluation was documented as normal,

fibrosis, or cirrhosis. Liver specimens were assessed blindly according to

the modified Ishak score. RESULTS: Demographic and clinical data of

procedure groups were comparable. Histologic grading alone diagnosed

cirrhosis in 22.3% (n=85) of liver specimens obtained by percutaneous route

compared with 26.0% (n=98) obtained by minilaparoscopy (P=0.270). By

combining macroscopy and histology, minilaparoscopic staging diagnosed a

significantly higher rate of liver cirrhoses with 33.8% (n=127) compared

with percutaneous route with 22.3% (n=85) (P=0.001). Analysis of

minilaparoscopic data revealed that 33 of the 128 cirrhoses were diagnosed

by inspection only, suggesting a 26% underestimation of cirrhosis by

histology alone. Severe complications occurred in 1.0% (n=4) of percutaneous

and in 0.2% (n=1) of minilaparoscopic procedures (P=0.025). CONCLUSIONS:

Minilaparoscopic evaluation based upon the combined macroscopic and

histologic assessment is more sensitive with regards to the detection of

cirrhosis and has a comparable safety profile.

PMID: 17198072 [PubMed - as supplied by publisher]

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[Guest guest]

J Clin Gastroenterol. 2007 Jan;41(1):103-110.

Prospective Randomized Comparison of Minilaparoscopy and Percutaneous Liver

Biopsy: Diagnosis of Cirrhosis and Complications.

Denzer U, Arnoldy A, Kanzler S, Galle PR, Dienes HP, Lohse AW.

*I Medical Department Johannes Gutenberg University Mainz, Mainz daggerI

Medical Department, University Medical Center Hamburg Eppendorf, Hamburg

double daggerInstitution for Pathology, University Medical Center Koln,

Koeln, Germany.

BACKGROUND AND AIMS: Liver cirrhosis represents an advanced stage of hepatic

fibrosis characterized by distortion of organ architecture and formation of

regenerative nodules. Retrospective series reported percutaneous liver

biopsy to miss cirrhosis in about 30%. The aim of this study was to

prospectively compare diagnostic sensitivity regarding the detection of

cirrhosis and the complication rates of percutaneous versus minilaparoscopic

liver biopsy in chronic liver disease. METHODS: Eight hundred fifty-seven

patients were randomized to percutaneous (415) or to minilaparoscopic liver

biopsy (442). Macroscopic liver evaluation was documented as normal,

fibrosis, or cirrhosis. Liver specimens were assessed blindly according to

the modified Ishak score. RESULTS: Demographic and clinical data of

procedure groups were comparable. Histologic grading alone diagnosed

cirrhosis in 22.3% (n=85) of liver specimens obtained by percutaneous route

compared with 26.0% (n=98) obtained by minilaparoscopy (P=0.270). By

combining macroscopy and histology, minilaparoscopic staging diagnosed a

significantly higher rate of liver cirrhoses with 33.8% (n=127) compared

with percutaneous route with 22.3% (n=85) (P=0.001). Analysis of

minilaparoscopic data revealed that 33 of the 128 cirrhoses were diagnosed

by inspection only, suggesting a 26% underestimation of cirrhosis by

histology alone. Severe complications occurred in 1.0% (n=4) of percutaneous

and in 0.2% (n=1) of minilaparoscopic procedures (P=0.025). CONCLUSIONS:

Minilaparoscopic evaluation based upon the combined macroscopic and

histologic assessment is more sensitive with regards to the detection of

cirrhosis and has a comparable safety profile.

PMID: 17198072 [PubMed - as supplied by publisher]

_________________________________________________________________

Get FREE Web site and company branded e-mail from Microsoft Office Live

http://clk.atdmt.com/MRT/go/mcrssaub0050001411mrt/direct/01/

[Guest guest]

J Clin Gastroenterol. 2007 Jan;41(1):103-110.

Prospective Randomized Comparison of Minilaparoscopy and Percutaneous Liver

Biopsy: Diagnosis of Cirrhosis and Complications.

Denzer U, Arnoldy A, Kanzler S, Galle PR, Dienes HP, Lohse AW.

*I Medical Department Johannes Gutenberg University Mainz, Mainz daggerI

Medical Department, University Medical Center Hamburg Eppendorf, Hamburg

double daggerInstitution for Pathology, University Medical Center Koln,

Koeln, Germany.

BACKGROUND AND AIMS: Liver cirrhosis represents an advanced stage of hepatic

fibrosis characterized by distortion of organ architecture and formation of

regenerative nodules. Retrospective series reported percutaneous liver

biopsy to miss cirrhosis in about 30%. The aim of this study was to

prospectively compare diagnostic sensitivity regarding the detection of

cirrhosis and the complication rates of percutaneous versus minilaparoscopic

liver biopsy in chronic liver disease. METHODS: Eight hundred fifty-seven

patients were randomized to percutaneous (415) or to minilaparoscopic liver

biopsy (442). Macroscopic liver evaluation was documented as normal,

fibrosis, or cirrhosis. Liver specimens were assessed blindly according to

the modified Ishak score. RESULTS: Demographic and clinical data of

procedure groups were comparable. Histologic grading alone diagnosed

cirrhosis in 22.3% (n=85) of liver specimens obtained by percutaneous route

compared with 26.0% (n=98) obtained by minilaparoscopy (P=0.270). By

combining macroscopy and histology, minilaparoscopic staging diagnosed a

significantly higher rate of liver cirrhoses with 33.8% (n=127) compared

with percutaneous route with 22.3% (n=85) (P=0.001). Analysis of

minilaparoscopic data revealed that 33 of the 128 cirrhoses were diagnosed

by inspection only, suggesting a 26% underestimation of cirrhosis by

histology alone. Severe complications occurred in 1.0% (n=4) of percutaneous

and in 0.2% (n=1) of minilaparoscopic procedures (P=0.025). CONCLUSIONS:

Minilaparoscopic evaluation based upon the combined macroscopic and

histologic assessment is more sensitive with regards to the detection of

cirrhosis and has a comparable safety profile.

PMID: 17198072 [PubMed - as supplied by publisher]

_________________________________________________________________

Get FREE Web site and company branded e-mail from Microsoft Office Live

http://clk.atdmt.com/MRT/go/mcrssaub0050001411mrt/direct/01/

[Guest guest]

J Clin Gastroenterol. 2007 Jan;41(1):103-110.

Prospective Randomized Comparison of Minilaparoscopy and Percutaneous Liver

Biopsy: Diagnosis of Cirrhosis and Complications.

Denzer U, Arnoldy A, Kanzler S, Galle PR, Dienes HP, Lohse AW.

*I Medical Department Johannes Gutenberg University Mainz, Mainz daggerI

Medical Department, University Medical Center Hamburg Eppendorf, Hamburg

double daggerInstitution for Pathology, University Medical Center Koln,

Koeln, Germany.

BACKGROUND AND AIMS: Liver cirrhosis represents an advanced stage of hepatic

fibrosis characterized by distortion of organ architecture and formation of

regenerative nodules. Retrospective series reported percutaneous liver

biopsy to miss cirrhosis in about 30%. The aim of this study was to

prospectively compare diagnostic sensitivity regarding the detection of

cirrhosis and the complication rates of percutaneous versus minilaparoscopic

liver biopsy in chronic liver disease. METHODS: Eight hundred fifty-seven

patients were randomized to percutaneous (415) or to minilaparoscopic liver

biopsy (442). Macroscopic liver evaluation was documented as normal,

fibrosis, or cirrhosis. Liver specimens were assessed blindly according to

the modified Ishak score. RESULTS: Demographic and clinical data of

procedure groups were comparable. Histologic grading alone diagnosed

cirrhosis in 22.3% (n=85) of liver specimens obtained by percutaneous route

compared with 26.0% (n=98) obtained by minilaparoscopy (P=0.270). By

combining macroscopy and histology, minilaparoscopic staging diagnosed a

significantly higher rate of liver cirrhoses with 33.8% (n=127) compared

with percutaneous route with 22.3% (n=85) (P=0.001). Analysis of

minilaparoscopic data revealed that 33 of the 128 cirrhoses were diagnosed

by inspection only, suggesting a 26% underestimation of cirrhosis by

histology alone. Severe complications occurred in 1.0% (n=4) of percutaneous

and in 0.2% (n=1) of minilaparoscopic procedures (P=0.025). CONCLUSIONS:

Minilaparoscopic evaluation based upon the combined macroscopic and

histologic assessment is more sensitive with regards to the detection of

cirrhosis and has a comparable safety profile.

PMID: 17198072 [PubMed - as supplied by publisher]

_________________________________________________________________

Get FREE Web site and company branded e-mail from Microsoft Office Live

http://clk.atdmt.com/MRT/go/mcrssaub0050001411mrt/direct/01/