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Cirrhosis, a chronic liver disease, can follow inflammatory liver disease (hepatitis), and is associated with complications such as liver failure, cancer, and cardiopulmonary complications. There is currently no definitive technique to diagnose cirrhosis. Blind liver needle biopsies, in which the liver is not viewed, have not been diagnostically effective. As a result, the true frequency of cirrhosis following chronic hepatitis is unclear. The effectiveness of combined laparoscopy (visual exploration of the abdomen) with needle biopsy was investigated in 92 children (64 female) aged 1 to 16 years with chronic hepatitis. Cirrhosis was found in 15 children with hepatitis B antigen (a protein indicative of hepatitis B infection), in one case, cirrhosis was not suspected by laparoscopic findings. Onset of cirrhotic symptoms, significant enlargement of the spleen, or loss of a hepatitis B protein from the blood were more frequently, but not consistently, found in cirrhotic patients. Cirrhosis was present in 41 of 46 patients with autoimmune (antibodies formed against one's own tissues) hepatitis. African or Asian family origins were a common factor in cirrhotic patients. Long-term follow-up of an average of 7.5 years showed that patients without cirrhosis remained well. Of patients with cirrhosis, 12 died, 7 others developed serious complications, and 5 received or were awaiting liver transplantation. Analysis of the extent of cirrhosis suggested that cirrhosis may be a part of chronic hepatitis from the outset, rather than the endpoint of disease. The effective diagnosis provided by the combination of laparoscopy plus biopsy allows proper treatment and follow-up care of children with chronic hepatitis. (Consumer Summary produced by Reliance Medical Information, Inc.)