Diagnosis of Diffuse Liver Disease by the Liver Surface Characteristics during Laparoscopic Surgery

Kim, Seung Ho; Park, Dong Eun; So, Byung Jun; Chae, Kwon Mook

Abstract

BACKGROUND/AIMS: The use of diagnostic laparoscopy has been changed because of the development of lesser invasive radiologic tools, which is more useful in the diagnosis of diffuse liver diseases recently. The aim of this study was to evaluate the clinical value of laparoscopy in diagnosis of diffuse liver diseases during laparoscopic surgery and to find the relationship between laparoscopic gross finding and liver biopsy. METHOD: Sixty-five patients were performed laparoscopic cholecystectomy from March 1. 2001 to July 30 . 2001. We prospectively compared the result of liver biopsy with preoperative serum liver function test, ultrasonographic finding and liver surface characteristics as observed during laparoscopic surgery.
RESULTS
The results of liver biopsy obtained in 59 cases were normal liver; 57.6%, mild steatosis; 15.4%, moderate to severe steatosis; 16.9%, chronic liver disease; 1.5%, cholangitis; 3.1% and cirrhosis; 1.5%. There was no correlation between preoperative liver function test and liver biopsy. However, the ultrasonographic finding was more correlated with liver diseases. The sensitivity of laparoscopic liver surface characteristics was 76.0%. The liver surface characteristics was well correlated with liver biopsy finding, especially in color of liver surface and contuor of liver margin. Importantly, when one more abnormal findings in liver surface characteristics were found, the positive predictability of liver disease was 56%.
CONCLUSIONS
Diagnostic laparoscopy is a safe and accurate method for evaluating the diffuse liver diseases. If the abnormal findings of liver surface characteristics is found during laparoscopic surgery, one shoud confirm liver disease by liver biopsy.