title: [The diagnosis of liver cirrhosis: a comparative evaluation of standard laparoscopy, mini-laparoscopy and histology].
abstract: BACKGROUND
  The superiority of laparoscopy with guided biopsy over biopsy alone is established. It is still uncertain if this is also true for midi-/ and mini-laparoscopy.
  
  
  OBJECTIVE
  The aim of this study was to determine the diagnostic gain of laparoscopic-guided biopsy for standard laparoscopy and the use of midi-/mini-laparoscopies. Characteristics of the liver biopsies were investigated with regard to a missed diagnosis of cirrhosis.
  
  
  METHODS
  In a consecutive series of 425 patients clinical, laparoscopic and histological findings were investigated. The length and fragmentation of the liver biopsies were investigated with regard to a missed diagnosis of cirrhosis.
  
  
  RESULTS
  The sensitivity of laparoscopy in the diagnosis of cirrhosis was 96 %, that of histology 68 %. The sensitivity of histology alone was especially low in macronodular cirrhosis. The sensitivity of both laparoscopy and histology improved from Child A to C. When cirrhosis was apparent, liver biopsies were shorter and more frequently fragmented. However, the diagnosis of cirrhosis was independent of these parameters.
  
  
  CONCLUSIONS
  Mini-laparoscopy may replace standard laparoscopy and appears to be superior compared with histology alone.
authors.affiliation: Medizinische Klinik C, Klinikum der Stadt Ludwigshafen gGmbH. weickeru@klilu.de
authors.forename: U
authors.initials: U
authors.lastname: Weickert
authors.forename: E
authors.initials: E
authors.lastname: Siegel
authors.forename: D
authors.initials: D
authors.lastname: Schilling
authors.forename: A
authors.initials: A
authors.lastname: Eickhoff
authors.forename: R
authors.initials: R
authors.lastname: Jakobs
authors.forename: M H
authors.initials: MH
authors.lastname: Bohrer
authors.forename: J F
authors.initials: JF
authors.lastname: Riemann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008103:Liver Cirrhosis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity