Artificial liver support as a bridge to orthotopic liver transplantation in a case of acute liver dysfunction on Non-Alcoholic SteatoHepatitis (NASH)
| Autor: | Antonio Gasbarrini, Mariano Alberto Pennisi, Vittorio Mignani, N. Gentiloni Silveri, Giorgio Conti, Rodolfo Proietti, Giovanna Mercurio, R. Gaspari, C. Di Campli |
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| Rok vydání: | 2001 |
| Předmět: |
Adult
Extracorporeal Circulation medicine.medical_specialty Cirrhosis medicine.medical_treatment Acute Liver transplantation Gastroenterology Hepatitis Renal Dialysis Internal medicine Preoperative Care medicine Humans Laparoscopy Serum Albumin medicine.diagnostic_test business.industry Settore MED/09 - MEDICINA INTERNA Extracorporeal circulation Fatty liver Liver Failure Acute Alcoholic medicine.disease Liver Artificial Liver Transplantation Surgery Fatty Liver Treatment Outcome Liver Liver biopsy Artificial Blood Component Removal Female Steatohepatitis business Liver Failure Fatty Liver Alcoholic |
| Zdroj: | Scopus-Elsevier |
| ISSN: | 1439-7803 0044-2771 |
| DOI: | 10.1055/s-2001-919025 |
| Popis: | INTRODUCTION 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). PATIENTS AND 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 (O 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. DISCUSSION 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. |
| Databáze: | OpenAIRE |
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