Clinical research of laparoscopic peritoneal exploration in diagnosis of unknown origin ascites

Objective:To assess the value of laparoscopic exploration in diagnosing unknown origin ascites.Methods:A total of 102 patients with unknown origin ascites underwent diagnostic laparoscopic abdominal exploration and biopsy from Mar.1993 to Dec.2009.Results:The etiological factor of 97 cases were identified by laparoscopic abdominal exploration and biopsy,there were 41 cases of tuberculous peritonitis.Surgical complications included 2 cases of bowel injury,1 case of secondary suture,and 7 cases of postoperative transient fever.There was no difference in diagnosis rate among different routine conventional imaging examinations(P0.05).Summation fee of routine examinations was more than laparoscopic exploration(P0.05),and the summation time of routine examinations was obviously longer than laparoscopic exploration(P0.01).There was no significant difference of serum carbohydrate antigen 125(CA125) concentrations between the cases of tuberculous peritonitis and abdominal extensive metastatic carcinoma on admission(P0.05).There were significant differences of serum CA125 concentrations between the patients with tuberculous peritonitis after 3 months treatment and their first serum CA125 test on admission(P0.01).Conclusions:The laparoscopic exploration in diagnosing unknown origin ascites is efficient,safe,feasible,economic and time-saving.Serum CA125 can be used as performance monitor in the patients with tuberculous peritonitis and an indicator of therapeutic effect.