TRENDS IN THE CAUSES AND OUTCOME OF LIVER CIRRHOSIS DIAGNOSED BY LAPAROSCOPY IN OSAKA, JAPAN DURING THE PAST THREE DECADES

Abstract

Background: Although various factors are assumed to have substantially altered the demographic characteristics of liver cirrhosis, few studies of patients with endoscopically confirmed cirrhosis have been done in Japan. We analyzed trends in causes and outcome of liver cirrhosis in Osaka, Japan during the past three decades.Method: The study group comprised 466 patients with cirrhosis of the liver who underwent laparoscopy at any time between 1969 and 1998. To analyze trends in the causes and outcome of cirrhosis, the study period was divided into three 10‐year intervals, variables included hepatitis B surface antigen (HBsAg), hepatitis C virus (HCV) antibody, alcohol intake, causes of death and outcome.Results: Hepatitis C virus has remained the major cause of liver cirrhosis during the past 30 years. Hepatitis B virus has remained the cause of liver cirrhosis in about 20–25% in all three decades. Alcohol played a part in the development of liver cirrhosis in more than 30% of the study group, alone or with hepatitis viruses. Therefore, alcohol remains an important factor in the pathogenesis of cirrhosis. The outcome of cirrhosis has improved gradually during the past decade owing to more effective means of treatment for complications of cirrhosis.Conclusion: Hepatitis C virus has remained the major cause of liver cirrhosis for the past three decades. Improvement of outcome in patients with cirrhosis caused by HCV infection should be an important task in the next decade.