Laparoscopic Histopathological Analysis of “Gentle Undulation” Findings observed in Patients with Primary Biliary Cirrhosis

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Abstract
Laparoscopic findings of the liver in 13 cases with primary biliary cirrhosis (PBC) diagnosed by wedge or needle biopsy were investigated. The characteristic features of laparoscopic appearance - gentle undulation - were observed in 11 out of 13 (85 %) patients with PBC. These gentle undulations were irregularly shaped areas from 0.5 to 3 cm in diameter. Those observed in s-PBC were greater in number and more pronounced than those in a-PBC. In the concave areas of these undulations, the number of portal tracts was significantly greater than in the convex areas (p < 0.005). On the contrary, the number of interlobular bile ducts in the concave area was significantly less than in the convex area (p < 0.005). Therefore, gentle undulation was relatively specific to PBC, and was caused by scar formation and chronic non-suppurative destructive cholangitis in the portal area.

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