The Clinical Value Of Laparoscopic Abdominal Exploration In Diagnosis Of Unexplained Ascites

Objective: To investigate the value of l Laparoscopic abdominal exploration indiagnosis of unexplained ascites. Methods: general information, clinical symptoms,preoperative examination results, laparoscopic laparotomy biopsy and biopsy results of93cases of unexplained ascites patients who administered in People’s Hospital of XinjiangUygur Autonomous Region during June1999and January2012were retrospectivelyanalysied. Results:89patients who had laparoscopic abdominal exploration had a cleardiagnosis after operation. the diagnosis rate was95.7%, four patients have negative testresults, the negative rate was4.3%;conventional auxiliary examinations, including B typeultrasound, CT, gastro duodenal endoscopy, abdominal paracentesis ascites andconventional Biochem (ADA、LDH), acid-fast bacilli, exfoliated cytology tests and serumtumor markers have no significant differences on the diagnosis of unexplained ascites;Characteristics of Various diseases under laparoscopy: tuberculosis peritonitis was ofmedium to large amount of ascites, with grass yellow colored, thin liquid. There areextensive gray military nodules with same sizes on peritoneum, and momentum, roughlyevenly distributed, and with more severe abdominal adhesions. Malignant tumor was ofmoderate to massive ascites, yellow or bloody. There can be seen nodules ranging in sizeof metastatic nodules, gray-red colored, easy bleeding, mainly on the peritoneum,momentum, intestine, mesentery and liver. in some cases, abdominal adhesions, comparedwith tuberculosis peritonitis, was light; surgical complications: there is a transient feverafter surgery in four cases; The sum of routine examination fees costs more than thelaparoscopy, the difference was statistically significant (P <0.05); The sum of time spentduring all routine tests were significantly longer than the laparoscopy.(P <0.01); onadmission, the serum CA125values have no significant differences,(P>0.05),betweenadvanced metastatic cancer and tuberculosis; The Serum CA125values in tuberculosisperitonitis between patients on admission and regular anti-TB treatment for3months,the difference was statistically significant (P <001) Conclusion: The pathological testsof laparoscopic biopsy under laparoscopic direct vision in patients with an unexplained ascites, will make up the inefficacy of radiologic imaging and laboratory tests. Diagnosticlaparoscopy technique of unexplained ascites was an efficient, more safe feasible andeconomical, time saving procedure.