Laparoscopic Findings of Asymptomatic Primary Biliary Cirrhosis —Particular investigation in early PBC—

Abstract

Abstract: of 17 cases of asymptomatic primary biliary cirrhosis (PBC), seven cases whose ALP (alkaline phosphatase) was less than twice the upper limit of the normal range were defined as being “early PBC”, and ten cases whose ALP was more than twice the upper limit of the normal range were defined as being “classical PBC” in order to investigate their clinical pictures and laparoscopic findings.There were no significant differences between early PBC and classical PBC in terms of sex differences, age, a positive rate of antimitochondrial antibody and histological findings. On the other hand, apart from IgM being as high as 86%, laboratory studies indicated that early PBC cases showed relatively low abnormal levels of GOT (29%), ALP (43%), γ‐GTP (57%), and erythrocyte sedimentation rate (ESR) (57%). Classical PBC cases exhibited almost 100% abnormal values.Laparoscopic examination of all the classical PBC cases revealed such specific characteristics of PBC as reddish patches, protuberance formations and mesh‐like white markings. Early cases revealed one of the following nonspecific findings: proliferation of the portal veins, irregularity of the liver surface, dullness of the liver edge and enlargement of the liver. However, in terms of the specific findings, none of the patients had reddish patches, and half of the patients demonstrated protuberance formations and mesh‐like white markings in part of the liver.