ROLE OF LAPAROSCOPY IN DIAGNOSIS AND MANAGEMENT OF CHRONIC ABDOMINAL DISORDERS
Ashish Kumar Dwivedi, Archana Shukla, Pradeep Kumar, M. C. Songra
Abstract
Ashish Kumar Dwivedi, Archana Shukla, Pradeep Kumar, M. C. Songra
Abstract
Diagnostic laparoscopy is being practiced for many decades by physicians and gynecologists. It is more frequently used in the diagnosis of various surgical disorders for last three decades. Many patients with chronic abdominal pain undergo various diagnostic tests with little or no change in their pain. Diagnostic laparoscopy may help in avoiding unnecessary laparotomy, provide accurate diagnosis and help in planning optimal therapy in these selected patients. Our objectives were to evaluate the role of laparoscopy in the diagnosis of chronic abdominal disorder and its impact on the management of these patients and to study the role of laparoscopy in preventing unnecessary laparotomy in selected medical patient and in patient with advanced abdominal malignancy. A retrospective study of 70 patients with chronic abdominal disorder admitted in a surgical unit in a government medical college from June 2009 to December 2011 was carried out. Most of these patients were investigated by the physician. Investigations include hematology, biochemistry, radiology, ascitic fluid analysis, endoscopic and imaging studies and the Monteux test. They were referred for elective diagnostic laparoscopy and tissue biopsy. Diagnostic laparoscopy confirmed the diagnosis in all patients suspected of malignancy. (5) There was 80% impact of diagnostic laparoscopy on the management of patients with chronic abdominal disorders in our study. Diagnostic laparoscopy is proven to have a significant diagnostic and therapeutic role in a patient with chronic abdominal disorder, where the diagnosis remained uncertain after the laboratory and non-invasive investigation.
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Diagnostic laparoscopy is being practiced for many decades by physicians and gynecologists. It is more frequently used in the diagnosis of various surgical disorders for last three decades. Many patients with chronic abdominal pain undergo various diagnostic tests with little or no change in their pain. Diagnostic laparoscopy may help in avoiding unnecessary laparotomy, provide accurate diagnosis and help in planning optimal therapy in these selected patients. Our objectives were to evaluate the role of laparoscopy in the diagnosis of chronic abdominal disorder and its impact on the management of these patients and to study the role of laparoscopy in preventing unnecessary laparotomy in selected medical patient and in patient with advanced abdominal malignancy. A retrospective study of 70 patients with chronic abdominal disorder admitted in a surgical unit in a government medical college from June 2009 to December 2011 was carried out. Most of these patients were investigated by the physician. Investigations include hematology, biochemistry, radiology, ascitic fluid analysis, endoscopic and imaging studies and the Monteux test. They were referred for elective diagnostic laparoscopy and tissue biopsy. Diagnostic laparoscopy confirmed the diagnosis in all patients suspected of malignancy. (5) There was 80% impact of diagnostic laparoscopy on the management of patients with chronic abdominal disorders in our study. Diagnostic laparoscopy is proven to have a significant diagnostic and therapeutic role in a patient with chronic abdominal disorder, where the diagnosis remained uncertain after the laboratory and non-invasive investigation.
Key concepts: Medicine, Laparoscopy, Laparotomy, Malignancy, Abdominal pain, General surgery, Surgery, Internal medicine