The correlation between sonographic diagnosis and laparoscopic observations on fatty liver.
BACKGROUND
Sonography is a comparatively cheap, convenient, and noninvasive testing on diagnosing fatty liver disease and with satisfied sensitivity and specificity. The sonographic diagnosis of fatty liver is usually made by radiologists who have few opportunities to observe the macroscopic changes on fatty liver. Having observed some obvious macroscopic changes of simple fatty liver in abdominal operations, we wanted to know how many morphological changes of the simple fatty liver there were in the end and what is the corresponding relationship between sonographic diagnosis and morphologic changes of the fatty liver. So, we designed this study for these destinations by using the intuitive and minimally invasive advantages of laparoscopy.


METHODS
For this study, we chose patients with benign cholecystic disease and simple fatty liver diagnosed by sonography. In the laparoscopic operations, the surface and periphery of the liver were observed and videotaped simultaneously. Liver biopsies were performed during the operations, and the specimen was analyzed by experienced pathologists postoperatively. The videos, histologic results, and the sonographic examinations on fatty liver were compared and tried to find some potential correlation among them.


RESULTS
In this study, we found some common macroscopic changes of the fatty liver under laparoscopy, such as hepatomegaly, the dullness of the liver edge, the fatty infiltration of the liver surface, the texture of the liver changing from softness to tenacity, and the blood vessels of the liver surface becoming more fuzzy. According to the histologic results, the characteristics of different gradings of fatty liver under laparoscopy could be confimed. The statistical analysis revealed a higher consistency between sonographic diagnosis and laparoscopic macroscopic changes of the fatty liver.


CONCLUSIONS
There are some typical features of the simple fatty liver under laparoscopy. These characteristics correspond to the sonographic diagnosis on the fatty liver. There is a high consistency between sonographic diagnosis and laparoscopic findings on the fatty liver. According to the macroscopic changes of the liver under laparoscopy, the extent of simple fatty liver could be evaluated under laparoscopy.
Yu
Wenbin
W
Department of General Surgery, The Second Hospital of Shandong University, Jinan, People's Republic of China.
Hu
Sanyuan
S
Qi
Yuzhong
Y
Li
Bo
B
D000328:Adult; D000368:Aged; D001706:Biopsy; D002764:Cholecystitis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D005234:Fatty Liver / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014463:Ultrasonography