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Value of liver biopsy combined with cholecystectomy
N P Zuegel1, J A Hehl, K Auerbach-Heber
1Department of General Surgery, Central Hospital Augsburg, Germany.
Background/Aims:
Many authors value routinely performed liver biopsy concomitant with cholecystectomy as a procedure of great diagnostic importance in regard to diagnosis and treatment of liver disease. Without reason, fewer perioperative liver punctures have been performed since the beginning of minimal invasive surgery, even so, laparoscopic cholecystectomy provides an equal opportunity for taking liver biopsies for diagnostic purposes. This study aims to determine the prevalence and extent of liver disease in patients undergoing cholecystectomy for gall stone disease.
Methodology:
Within the pre-laparoscopic era, 565 cholecystectomies with concomitant liver biopsies were performed. The results were evaluated retrospectively. Serious pathohistologic findings were defined by the stage of pathologic changes demanding prognostic and/or therapeutic consequences.
Results:
One hundred and ten patients (19.5%) had normal liver biopsies. Severe pathologic liver changes were diagnosed in 58 (10.3%). Taking all liver biopsies showing liver changes, prognostic and therapeutic relevance were represented in 52% of our patients.
Conclusions:
Having proof of the high rate of pathologic liver changes resulting in liver disease we advocate liver biopsy in connection with cholecystectomy as an important procedure, if open or laparoscopic surgery of the extrahepatic biliary tract is performed.