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Stephen L. Michel, MD; Robert Lipsky, MD; Leon Morgenstern, MD

Arch Surg. 1977;112(8):959-961.

Abstract
• Liver biopsy was done at the time of operation in 125 consecutive upper abdominal procedures to assess the incidence of unsuspected or undiagnosed hepatic abnormalities. Specifically excluded were hepatic lesions unexpectedly identified at laparotomy. Sixty-seven percent of the liver biopsy specimens were abnormal, the most frequent findings being fatty metamorphosis, cholestasis, triaditis, fibrosis, inflammatory infiltrate, cholangitis, cirrhosis, and hepatitis. The most frequent operation performed was cholecystectomy. In 63 patients with chronic cholecystitis, there was a 51% incidence of abnormal liver histology, while in nine patients with acute cholecystitis, the incidence was 78%. In 83% of all other operations, abnormal liver biopsy specimens were identifed. Bile leakage, hemorrhage, and infection did not occur in this series, despite inclusion of patients with severe biliary obstruction, abnormal clotting factors, and intra-abdominal sepsis. New techniques of histochemical enzyme analysis and electron microscopy are expected to enhance the clinical correlation of occult hepatic lesions. We conclude that liver biopsy is a safe, informative adjunct to all upper abdominal procedures.

(Arch Surg 112:959-961, 1977)

Author Affiliations
From the Department of Surgery, Cedars-Sinai Medical Center, Los Angeles.

Footnotes
Accepted for publication Feb 22, 1977.

Read before the annual meeting of the Southern California Chapter of the American College of Surgeons, Palm Springs, Calif, Jan 16, 1977.

Reprint requests to Department of Surgery, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA 90048 (Dr Michel).

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