title: Diagnostic laparoscopy in the era of modern imaging--retrospective analysis from a single center.
abstract: BACKGROUND
  A retrospective analysis of utility and outcomes of diagnostic laparoscopy at our center in the last 5 years was done.
  
  
  METHODS
  In the last 5 years, we subjected 90 patients to diagnostic laparoscopy (DL) when final diagnosis could not be achieved after all necessary imaging methods and serological, cytological, and microbiological investigations. DL was performed under sedation and local anesthesia, and patients were discharged within 24 h. Video documentation along with guided biopsies/collection of the samples for culture and other tests was performed.
  
  
  RESULTS
  The commonest indication was ascites (46/90), followed by diffuse liver disease (15), focal liver disease (9), intraabdominal malignancies (10), and miscellaneous (10). Overall accuracy of DL was 91 %. In 64 % of patients, laparoscopy confirmed the clinical diagnosis, and in 27 % of patients, laparoscopy was useful in correcting the diagnosis. DL was performed in 46 patients with low-serum ascitic fluid albumin gradient ascites and ascites of mixed etiology. DL confirmed the suspected diagnosis in 48 %, corrected in 38 %, and yielded unsuspected diagnosis in 15 % patients. In 6 % of patients, laparoscopy was inconclusive. In three patients, there were extensive intraperitoneal adhesions, and adequate examination was not possible. No serious complications were encountered. Minor complications of pain at the port site, ascitic fluid leakage, and port site infection were seen in three, two, and one patient, respectively.
  
  
  CONCLUSIONS
  DL is useful in patients when diagnosis and extent of the disease were unclear especially in ascites of undetermined etiology.
authors: Department of Gastroenterology and Hepatology, Bombay Hospital and Medical Research Centre, 12, Marine Lines, Mumbai 400 020, India. amarapurkar@gmail.com
authors: Deepak
authors: D
authors: Amarapurkar
authors: Nirav
authors: N
authors: Bhatt
authors: Nikhil
authors: N
authors: Patel
authors: Pooja
authors: P
authors: Amarapurkar
authors: Anjali
authors: A
authors: Amarapurkar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001201:Ascites / Q000209:etiology*; D002648:Child; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008107:Liver Diseases / Q000175:diagnosis; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis*; D012189:Retrospective Studies; D014376:Tuberculosis / Q000175:diagnosis; D055815:Young Adult
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