Peritoneoscopy in chronic hepatitis. A retrospective evaluation of its role in the management of the asymptomatic patient.
The course of chronic hepatitis was retrospectively evaluated in 26 patients in whom both peritoneoscopy and liver biopsy were initially performed. At entry all patients were clinically asymptomatic and showed mild or moderate histological and chemical abnormalities, so that none of them needed steroid treatment. The duration of the follow-up ranged from 24-82 months. At the end of follow-up liver biopsy was obtained in all patients. In a few patients peritoneoscopy was also ultimately performed. In six patients in whom initially chronic persistent hepatitis (CPH) was diagnosed both by peritoneoscopy and liver biopsy, the subsequent course of the disease was benign. In all the nine patients in whom initially peritoneoscopy suggested CPH, in contrast to the histological diagnosis of chronic aggressive hepatitis (CAH), chemical and morphological parameters of liver disease activity did not worsen to require steroid treatment. In five of six patients in whom both liver biopsy and peritoneoscopy initially showed CAH, chemical and morphological abnormalities progressed so that steroids had to be initiated. Finally in four of five patients in whom initially peritoneoscopy showed CAH and liver biopsy CPH, steroid treatment was ultimately required because of chemical and morphological worsening. In conclusion peritoneoscopy may be a useful aid in the management of the asymptomatic patient with moderate chemical and histological features of chronic liver disease.
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D001706:Biopsy; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006505:Hepatitis / Q000175:diagnosis* / Q000188:drug therapy / Q000628:therapy; D006801:Humans; D010535:Laparoscopy; D008099:Liver / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
D000305:Adrenal Cortex Hormones