Histopathological assessment of the liver in cholelithiasis with cholecystitis

Liver function and histology were studied in 62 patients undergoing elective cholecystectomy. Data from 50 of the cases was subsequently analyzed. Liver function was assessed by biochemical parameters and histological examination of intraoperatively obtained core and wedge liver biopsy. There were no complications associated with the procedure of liver biopsy. Seventy-eight percent of liver biopsies showed some form of abnormality, the commonest being mild portal tract infiltration. Eighteen percent of patients had severe histological abnormalities. Fourteen percent of bile samples were infected. No correlation was found among age, symptom duration, liver function tests, and histological appearance. Biliary infection was associated with a significant incidence of fatty change and inflammatory cell infiltration of parenchyma. We observed a high rate of abnormal liver histology of unknown clinical significance in patients of calculous cholecystitis. These changes are not reflected in commonly performed tests of liver function. Intraoperative liver biopsy is a safe and sensitive method to detect liver abnormalities.