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La laparoscopie dans la cholostase

Laparoscopy in cholestasis

La laparoscopia en el estudio de la colostasis

  • Published:
Acta Endoscopica

Résumé

Les auteurs ont étudié rétrospectivement 40 cas d’ictère dont l’évaluation clinique (fondée sur l’anamnèse, l’examen physique et les tests biologiques) a abouti à un diagnostic inexact. L’échographie a mis en évidence la perméabilité des voies biliaires, excluant une cholostase extra-hépatique et a conduit au diagnostic d’ictère par cholostase intra-hépatique, sans permettre une sub-classification ultérieure entre causes non-obstructives aiguës ou chroniques. La laparoscopie avec biopsies guidées a permis un diagnostic correct des diverses affections parenchymateuses responsables de la cholostase intra-hépatique et les auteurs discutent le rôle diagnostique de la laparoscopie dans ces cas particuliers d’ictère.

Summary

The authors retrospectively studied 40 jaundiced patients in which the clinical evaluation (based on history, physical examination and chemical tests) did allow an appropriate diagnosis. US demonstrated the patency of the bile ducts and this excluded extrahepatic cholestasis and lead to the conclusive diagnosis of intrahepatic jaundice, without the possibility of further subclassification into acute or chronic nonobstructive states. Laparoscopy with guided liver biopsy allowed a correct diagnosis of the various parenchymal liver diseases responsable for intrahepatic cholestasis and the authors discuss the diagnostic role of laparoscopy in these particular cases of jaundice.

Resumen

Los autores han estudiado retrospectivamente 40 casos de ictericia cuya evaluación clínica (basada en la anamnesis, el examen fisico y los tests biológicos) dió lugar a una diagnóstico inexacto. La ecografía puso en evidencia la permeabilidad de las vías biliares, excluyendo una colostasis extrahepática y llevó a un diagnóstico de ictericia por colostasis intrahepática, sin permitir una subclasificación ulterior entre etiologías no obstructivas agudas o crónicas. La laparoscopia con biopsias dirigidas permitió un diagnóstico correcto de las diveras afecciones parenquimatosas responsables de la colostasis intrahepática y los autores discuten el papel diagnóstico de la laparoscopia en estos casos particulares de ictericia.

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  1. Institute of Internal Medicine, University of Padua, Padova, Italy

    R. Orlando & S. Sawadogo

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Orlando, R., Sawadogo, S. La laparoscopie dans la cholostase. Acta Endosc 20, 537–543 (1990). https://doi.org/10.1007/BF02966783

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