Role of hepatic histologic findings in the prognosis and treatment of bleeding esophageal varices

Bruno Andreoni, Osvaldo Chiara, Dario Maggioni, Angelo Nespoli, Roberto Biffi, Giuseppe Bevilacqua

Research output: Contribution to journalArticle

Abstract

In the period from 1976 to 1986, we performed 329 hepatic needle biopsies using a posterior extraperitoneal approach in patients with bleeding esophageal varices. The histologic findings subdivided according to a four-stage classification were correlated significantly with immediate survival. Specifically, 21 of 23 stage IV patients with severe degenerative and necrotic parenchymal lesions died after immediate emergency surgery, whereas 26 of 48 stage IV patients who did not undergo emergency surgery survived. Stage IV patients appeared unable to withstand major surgery. According to our data, histologic stage and Child's class are independent parameters, especially in emergency situations, since they quantify different aspects of functional liver failure. Therapeutic implications are presented based on cumulative analysis of histologic stages and Child's classes.

Original languageEnglish
Pages (from-to)220-224
Number of pages5
JournalAmerican Journal of Surgery
Volume157
Issue number2
DOIs
Publication statusPublished - 1989

ASJC Scopus subject areas

  • Surgery

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