title: What is the role of diagnostic laparoscopy in a gastroenterology unit?
abstract: BACKGROUND
  Diagnostic laparoscopy is known to be a relatively safe invasive procedure. However, its use has decreased owing to the development of imaging techniques, and fewer gastroenterologists now practice diagnostic laparoscopy. Our aim was to examine the role of diagnostic laparoscopy in a gastroenterology unit in the era of advanced imaging techniques.
  
  
  METHODS
  We retrospectively reviewed 855 diagnostic laparoscopy cases. Its safety and efficacy were evaluated for various indications.
  
  
  RESULTS
  No mortality was observed, and complications were noted in ten patients (1.2%). Among the indications were evaluation of chronic liver disease (n = 673), liver tumor (n = 15), ascites of unknown origin and peritoneal disease (n = 142), and staging of intra-abdominal malignancy (n = 25). In patients with chronic liver disease, 461 were diagnosed as having chronic viral hepatitis, based on clinical data including imaging studies, but the diagnosis was changed to cirrhosis after a laparoscopic exam in 69 patients (15.0%). In patients with ascites of unknown origin and peritoneal disease, the diagnostic yield was 87.2% (123/141). In 24 (19.5%) of the 123 patients, the diagnosis changed or the less probable diagnosis was confirmed after laparoscopic examination. The confirmed diagnoses were mainly primary peritoneal disease, including peritoneal tuberculosis, in 17 patients, peritoneal metastatic carcinoma in five, and mesothelioma in two.
  
  
  CONCLUSIONS
  Diagnostic laparoscopy in a gastroenterology unit is safe and useful, especially for confirmation of liver cirrhosis and primary peritoneal disease evaluation.
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemoon-gu, Seoul 120-752, Korea.
authors.forename: Young Joon
authors.initials: YJ
authors.lastname: Yoon
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Ahn
authors.forename: Jun Yong
authors.initials: JY
authors.lastname: Park
authors.forename: Chae Yoon
authors.initials: CY
authors.lastname: Chon
authors.forename: Do Young
authors.initials: DY
authors.lastname: Kim
authors.forename: Young Nyun
authors.initials: YN
authors.lastname: Park
authors.forename: Kwang-Hyub
authors.initials: KH
authors.lastname: Han
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D005762:Gastroenterology / Q000379:methods*; D006757:Hospital Units; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000706:statistics & numerical data*; D008103:Liver Cirrhosis / Q000175:diagnosis*; D008107:Liver Diseases / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D010532:Peritoneal Diseases / Q000175:diagnosis*