[Value of laparoscopy in the diagnosis of chronic nonsuppurative destructive cholangitis]

39 female and 5 male patients with chronic non-suppurative destructive cholangitis (CNDC), excluding cases with the complete picture of a primary biliary cirrhosis, were examined. Besides clinical and immunological investigations in all patients laparoscopy was performed, in 18 cases repeatedly in order to control the course. As typical laparoscopic appearance in 43 of the cases we saw geographically outlined and generally communicating areas on the liver surface within somewhat brighter surroundings ("map-like-phenomenon"). Besides this a darker coloration in the center of the liver lobules was significant ("leopard skin-phenomenon"). Regarding the size, the consistency, the shape of the edge, and the structure of the surface of the liver we determined different stages of the disease. Our scale showed a good correlation to the copper-content of the liver, but did not always correlate to Scheuer's histological scheme. The significant uncertainties of histopathological interpretations of the findings in early stages of CNDC as well as differential diagnostic considerations are discussed. According to our results we believe that laparoscopy can significantly contribute to solve the diagnostic problems.