[Value of minilaparoscopy in comparison with conventional laparoscopy in diagnosis of liver diseases--intermediate term results of a prospective, randomized study].
BACKGROUND
Laparoscopy plays an essential role in the diagnosis of hepatic diseases. During the past few years, minilaparoscopy (ML) has increasingly emerged as an alternative diagnostic method in this field. We hereby present the preliminary results of a randomized trial comparing ML with conventional laparoscopy (CL).


METHODS
92 with suspected hepatic disease were randomized either to undergo CL (n = 47) or ML (n = 45). For CL, we used a Hopkins-laparoscope (Ø 11 mm, Storz, Tuttlingen) and ML was performed with a 1.9 mm small-diameter optic (Wolf, Knittlingen).


RESULTS
Laparoscopy with simultaneous liver biopsy could successfully be performed in 88/92 patients. ML could be performed in a significantly shorter time than CL (25 vs. 28 min, p < 0.05). Liver cirrhosis was diagnosed by laparoscopy in a similar proportion of patients (70% in CL, 56% in ML). In 76% of cases, histology confirmed macroscopic signs of liver cirrhosis. Cirrhosis was found in one patient of each group solely by histologic examination of biopsy specimens. The number of bleeding complications during CL equaled the proportion of hemorrhagias in the ML-group.


CONCLUSIONS
In the workup of hepatic disease, ML is a diagnostic tool comparable with CL. The fact that ML can be performed in significantly shorter time and seems subjectively less invasive might be an argument for a better acceptance by patients.
Schneider
A R
AR
Medizinischen Klinik C, Klinikum Ludwigshafen, Akademisches Lehrkrankenhaus der Universität Mainz.
Riemann
J F
JF
Arnold
J C
JC
D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000295:instrumentation; D004867:Equipment Design; D005260:Female; D006474:Hemorrhagic Disorders / Q000473:pathology; D006801:Humans; D020706:Laparoscopes; D008099:Liver / Q000473:pathology; D008107:Liver Diseases / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies
Stellenwert der Minilaparoskopie im Vergleich zur konventionellen Laparoskopie in der Diagnostik von Lebererkrankungen--Zwischenergebnisse einer prospektiven, randomisierten Studie.