Résumé
Depuis l’introduction et le large emploi des nouvelles techniques d’imagerie telles que l’ultrasonographie (US), la tomographie computérisée (TC), les indications de la laparoscopie ont été modifiées. Néanmoins, nos résultats concernant 180 patients ictériques montrent que la laparoscopie demeure une technique d’investigation efficace dans le diagnostic de I’ictère, en particulier lorsque les causes de celui-ci résultent d’une affection hépatique diffuse telle qu'une hépatite chronique, une cirrhose, une cirrhose biliaire primitive ou de métastases hépatiques.
En conclusion, cette technique doit etre réalisée lorsque tous les precédés ont échoué dans la tentative d’établir le diagnostic final, ce qui dans la plupart des cas permet d’éviter une laparotomie exploratrice.
Summary
Following the introduction and widespread use of newer imaging techniques such as ultrasonography (US), computed tomography (CT), the indications for laparoscopy have changed. However, our results concerning 180 jaundiced patients show that laparoscopy remains an efficient mean of investigation for the diagnosis of jaundice, particularly when this disorder is due to a diffuse liver disease such as chronic hepatitis, cirrhosis, PBC, hepatic metastases.
In conclusion, this technique should be carried out when other procedures have failed to establish a final diagnosis, thus avoiding exploratory laparotomy in most cases.
Resumen
Desde la introducción y gran utilización de nuevas técnicas de imagen (ultrasonografía US y tomografía computarizada TC), las indicaciones de la laparoscopia se han visto modificadas. Sin embargo, los resultados de un estudio de 180 pacientes con ictericia desmuestran que la laparoscopia continúa siendo una lécnica eficaz de estudio en el diagnóstico de la ictericia, en particular cuando la causa de la misma se debe a una afección difusa, tal como la hepatitis crónica, la cirrosis, la cirrosis biliar primitiva o las metástasis hepáticas.
En conclusion, esta lécnica debe ser realizada en los casos en los que las demás exploraciones no hayan logrado el diagnostico final, lo que permite además, evilar laparotomías exploradoras.
This is a preview of subscription content, log in via an institution to check access.
References
ANTHONY P.P., ISHAK K.G., NOYAK N.C., POULSEN H.E., SCHEUER P.J., SABIN L.H. — The morphology of cirrhosis.J. Clin. Pathol., 1978,31, 395–414.
Beck K. — Atlante di laparoscopica. Leonardo Edizioni Scientifiche, Roma, 1970.
BIANCHI L., DE GROOTE J., DESMET V.J., GEDIGK P., KORB G., POPPER H., POULSEN H., SCHEUER P., SCHMID M., THALER H. — Acute and chronic hepatitis revisited.Lancet. 1977,ii, 914–919.
BOYCE H.W. — Laparoscopy in: Schiff L., Schiff E.R. Eds. Disease of the liver. Philadelphia, J.B. Lippincott, 1982, 333–348.
BUFFET C., PELLETIER G., ETIENNE J.P. — Que reste-t-il des indications de la laparoscopic en 1983?Gastroenterol. Clin. Biol., 1983,7, 134–140.
BRUGUERA M., BORDAS J.M., MASSA P., RODES J. — A comparison of the accuracy of peritoneoscopy and liver biopsy in the diagnosis of cirrhosis.Gut, 1974,15, 799–800.
CALVET X., BORDAS J.M., MODELO F., GARCIAPAGAN J.C., BRUGUERA M., RODES J. — La exploracion laparoscopica antes y despues de la introducion de la ultrasonografia en el diagnostico de la patologia hepatica y abdominal.Gastroenterologia y Hepatologia, 1988,11, 75–78.
DE GROOTE J., DESMET V.J., GEDIGK P., KORB G., POPPER H., POULSEN H., SCHEUER P., SCHMID M. THALER H., VEHLINGER E., WEPLER W. — A classification of chronic hepatitis.Lancet, 1968,ii, 626–628.
FORNARI F., RAPACCINI G.L., CAVANNA L., CIVARDI G., ANTI M., FEDELI G., BUSARINI L. — Diagnosis of hepatic lesions: ultrasonically-guided fine needle biopsy or laparoscopy?Gastrointest. Endosc., 1988,34, 231–234.
GANDOLFI L., ROSSI A., LEO P., SOLMI L., MURATORI R. — Indications for laparoscopy before and after the introduction of ultrasonography.Gastrointest. Endosc., 1985,31, 1–3.
LIGHTDALE C.J. — Laparoscopy in the age of imaging.Gastrointest. Endosc., 1985,31, 47–48.
LINDNER H., DAMMERMANN R., KLOPPEL G. — The laparoscopic staging of primary biliary cirrhosis.Endoscopy, 1977,9, 68–73.
LUTZ H. — Ultrasonically-guided fine-needle puncture in gastroenterology.Endoscopy, 1983,15, 180–182.
MANSI C., SAVARINO V., PICIOTTO A., TESTA R., CAMPA A., DODERA M., GELLE G. — Comparison between laparoscopy, ultrasonography, and computed tomography in widespread and localized liver diseases.Gastrointest. Endosc., 1982,28, 83–85.
MEIRE H.B., HUSBAND J. — Demonstration of focal liver disease by ultrasound and computed tomography. In: Taylor K.J.W. ed., Diagnostic ultrasound in gastrointestinal disease. New York, Churchill Livingstone, 1979, 35–58.
MORENO-SANCHEZ D., HERRUZO J.A. — Imagen laparoscopica de la cirrosis biliar primaria.Gastroenterologia y Hepatologia, 1988,11, 116–122.
MORL M. — Lapararoscopy. Present situation and prospects.Endoscopy, 1987,19, 167–168.
ORLANDO R., LIRUSSI F., NASSUATO G., OKOLIC-SANYI L. — Complications of laparoscopy in the elderly: a report on 345 consecutive cases and comparison with a younger population.Endoscopy, 1987,19, 145–146.
ORLANDO R., LIRUSSI F., MURACA M., NACCARATO R., OKOLICSANYI L. — Smooth liver surface may conceal cirrhosis. Evidence for the late development of nodular surface of the cirrhotic liver.Endoscopy, 1988,20, 323–325.
ORLANDO R., LIRUSSI F., OKOLICSANYI L. — Is laparoscopy useful in the follow-up of chronic hepatitis?Acta Endosc., 1989,19, 1–9.
PAGLIARO L., RINALDI F., CRAXI A., DI PIAZZA S., FILIPPAZZO G., GATTO G., GENOVA G., MAGRIN S., MARINGHINI A., ORSINI S., PALAZZO U., SPINELLO M., VINCI M. — Percutaneous blind biopsy versus laparoscopy with guided biopsy in the diagnosis of cirrhosis. A prospective randomized trial.Dig. Dis. Sci., 1983,28, 39–43.
PAOLAGGI J.A., ALGARD M., BARRET C. FERRANDI F., BERTRAND H.J. — Indications actuelles de la laparoscopie.Ann. Med. Interne, 1987,138, 86–89.
POPPER H. — The problem of histological evaluation of primary biliary cirrhosis.Virchows Arh. A. Path. Anat. and Histol., 1978,379, 99–104.
SCHEUER P.J. — Primary biliary cirrhosis.Proc. Roy Soc. Med., 1967,60, 1257–1260.
SCHEUER P.J. — Cirrhosis. In: MacSween R.N.M., Anthony P.P., Scheuer P.J. (eds). Pathology of the Liver. London, 1974, Churchill Livingstone, pp. 258–271.
SOLIS-HERRUZO J.A. — Diagnostico laparoscopico de las hepatitis.Rev. Esp. Enf. Ap. Digest., 1974,44, 351–364.
VIDO I., WILDHIRT E. — Korrelation des laparoskopischen und histologischen Befundes bei chronischer Hepatitis und Leberzirrhose.Dtsch. Med. Wscht., 1969,94, 1633–1637.
VOGEL H.M., SCHERER K., LOOK D. — Comparative studies of laparoscopy, histology and gray-scale echotomography in diffuse diseases of the liver.Endoscopy, 1980,12, 166–174.
Author information
Authors and Affiliations
About this article
Cite this article
Orlando, R., Lirussi, F. & Okolicsanyi, L. La laparoscopie est-elle encore utile au diagnostic étiologique de I’ictère?. Acta Endosc 19, 275–280 (1989). https://doi.org/10.1007/BF02962690
Issue Date:
DOI: https://doi.org/10.1007/BF02962690