title: High Prognostic Value of Mini-Laparoscopy for Advanced Liver Disease-Related Complications in Patients with HCV Infection.
abstract: OBJECTIVE
  The assessment of advanced chronic liver disease (ACLD) is a prerequisite for therapy and surveillance in patients with chronic hepatitis C infection. Mini-laparoscopy-assisted liver biopsies facilitate both histological and macroscopical evaluation of liver fibrosis. This study is aimed at investigating the prognostic significance of the laparoscopic assessment for the cumulative incidence of ACLD-related events.
  
  
  METHODS
  We performed a single center, retrospective analysis of 94 patients with either macroscopically or/and microscopically assessed advanced fibrosis/cirrhosis caused by chronic hepatitis C infection. The patients' data, the respective laboratory results, and follow-up period were evaluated in the outpatient clinic.
  
  
  RESULTS
  The group with both macro- and microscopic diagnosed ACLD showed a significantly higher number of decompensating events (n = 7) compared with the other 2 groups (n = 0 in the group with only histological and n = 1 in the group with only laparoscopic diagnosis of advanced liver disease). The results were not affected by the successful treatment of the hepatitis C virus. In the Cox-regression analysis, the spleen size (>120 mm) was significantly associated with the incidence of ACLD-related events.
  
  
  CONCLUSIONS
  Assessment of ACLD in chronic hepatitis C by mini-laparoscopy-assisted liver biopsies may facilitate the selection of patients with a poor prognosis, irrespective of achieving a sustained virological response following treatment. Follow-up of these patients should be intensified to treat decompensation early.
authors.affiliation: Klinik für Innere Medizin 1, University of Ulm, Ulm, Germany.
authors.forename: Eugen
authors.initials: E
authors.lastname: Zizer
authors.forename: Johanna
authors.initials: J
authors.lastname: Backhus
authors.forename: Stephan
authors.initials: S
authors.lastname: Bohl
authors.forename: Anette
authors.initials: A
authors.lastname: Braun
authors.forename: Irina
authors.initials: I
authors.lastname: Baturina
authors.forename: Dietmar
authors.initials: D
authors.lastname: Klass
authors.forename: Nektarios
authors.initials: N
authors.lastname: Dikopoulos
authors.forename: Thomas
authors.initials: T
authors.lastname: Seufferlein
authors.forename: Matthias
authors.initials: M
authors.lastname: Dollinger
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D001706:Biopsy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D016174:Hepacivirus / Q000187:drug effects / Q000302:isolation & purification; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000379:methods*; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000453:epidemiology* / Q000473:pathology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000998:Antiviral Agents