Diagnosis and Management of Liver Disease: An Update in 2023

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (30 November 2023) | Viewed by 4866

Special Issue Editor


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Guest Editor
Department of General Surgery and Liver Transplantation, Fundeni Institute Bucharest, Bucharest, Romania
Interests: hepatocellular carcinoma; cirrhosis laparoscopic surgery; liver surgery; hepatobiliary surgery; liver transplantation; liver cirrhosis; liver diseases
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Special Issue Information

Dear Colleagues,

Liver diseases are an important health issue with an increasing incidence worldwide. From diffuse parenchymal impairment—due to infectious, toxic, metabolic, vascular, autoimmune factors or congenital malformations—leading to steatosis, fibrosis, hepatitis, cholangiopathies and/or cirrhosis, to primary or secondary focal liver lesions, the diagnosis must be precise and made in the early stages of disease, independently of its presentation—acute, chronic, acute-on-chronic or end-stage liver disease. Only in this way can patients receive the best care. Laboratory tests, imaging techniques, liver and/or tumor biopsy and pathological findings after surgery are essential tools for diagnosis that trigger specific therapeutic protocols based on a series of medical, interventional and surgical therapies, including liver resection and transplantation. Moreover, in surgical patients, diagnosis, with its corresponding therapeutic protocols, is a continuous process during preoperative (lab tests, imaging, biopsy); intraoperative (ultrasound, cholangiography, fluorescence imaging, etc.); and postoperative phases (lab tests, imaging, pathological findings).

This Special Issue is an update for internists, radiologists, gastroenterologists, hepatologists, anesthesiologists, pathologists and liver surgeons in the assessment and management of patients with liver disease.

Dr. Florin Botea
Guest Editor

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Published Papers (1 paper)

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Research

12 pages, 1900 KiB  
Article
Differentiation of Spontaneous Bacterial Peritonitis from Secondary Peritonitis in Patients with Liver Cirrhosis: Retrospective Multicentre Study
by Silvia Würstle, Alexander Hapfelmeier, Siranush Karapetyan, Fabian Studen, Andriana Isaakidou, Tillman Schneider, Roland M. Schmid, Stefan von Delius, Felix Gundling, Rainer Burgkart, Andreas Obermeier, Ulrich Mayr, Marc Ringelhan, Sebastian Rasch, Tobias Lahmer, Fabian Geisler, Paul E. Turner, Benjamin K. Chan, Christoph D. Spinner and Jochen Schneider
Diagnostics 2023, 13(5), 994; https://doi.org/10.3390/diagnostics13050994 - 06 Mar 2023
Cited by 1 | Viewed by 4429
Abstract
Ascitic fluid infection is a serious complication of liver cirrhosis. The distinction between the more common spontaneous bacterial peritonitis (SBP) and the less common secondary peritonitis in patients with liver cirrhosis is crucial due to the varying treatment approaches. This retrospective multicentre study [...] Read more.
Ascitic fluid infection is a serious complication of liver cirrhosis. The distinction between the more common spontaneous bacterial peritonitis (SBP) and the less common secondary peritonitis in patients with liver cirrhosis is crucial due to the varying treatment approaches. This retrospective multicentre study was conducted in three German hospitals and analysed 532 SBP episodes and 37 secondary peritonitis episodes. Overall, >30 clinical, microbiological, and laboratory parameters were evaluated to identify key differentiation criteria. Microbiological characteristics in ascites followed by severity of illness and clinicopathological parameters in ascites were the most important predictors identified by a random forest model to distinguish between SBP and secondary peritonitis. To establish a point-score model, a least absolute shrinkage and selection operator (LASSO) regression model selected the ten most promising discriminatory features. By aiming at a sensitivity of 95% either to rule out or rule in SBP episodes, two cut-off scores were defined, dividing patients with infected ascites into a low-risk (score ≥ 45) and high-risk group (score < 25) for secondary peritonitis. Overall, the discrimination of secondary peritonitis from SBP remains challenging. Our univariable analyses, random forest model, and LASSO point score may help clinicians with the crucial differentiation between SBP and secondary peritonitis. Full article
(This article belongs to the Special Issue Diagnosis and Management of Liver Disease: An Update in 2023)
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