THE VALUE OF LAPAROSCOPY IN ASCITES OF UN KNOWN ORIGIN

Objetive: To assess the diagnostic accuracy of laparoscopy in the stud y of patients with ascites of unknown cause, and the frequency of lapa roscopy use for that indication after the advent of ultrasonography an d computed tomography. Design: A retrospective study of 4.536 laparosc opies performed in 16 years, in two periods of 8 years, and the correl ation with the pathologic diagnosis, Patients: 137 patients in whom la paroscopy was indicated for the study of ascites of unkown cause. Resu lts: 63.5% of laparoscopies were performed over the first 8-year perio d, and 36.5% in the second (p = 0.0001), and for the study of ascites 2.6 and 3.8% respectively, Laparoscopy and biopsy were diagnostic in 9 8.5% of cases; 51% carcinomatosis, 17.5% liver cirrhosis, 11.7% hepati c neoplasm and others. Two of five cases of peritoneal tuberculosis we re considered carcinomatosis at laparoscopy, There were no serious com plications, Conclusions: The advent of new imaging method has reduced the use of laparoscopy, although it is still employed frequently for t he study of ascites. Laparoscopy with biopsy when necesary has an exce llent effectiveness and accuracy for the diagnosis of ascites of unkno wn cause.