The role of diagnostic laparoscopy in patients with ascites

Abstract

Background: Ascites, the abnormal accumulation of fluid in the peritoneal cavity, is a common clinical condition with multiple causes. Effective management is essential to improve quality of life and prevent complications. Laparoscopy, a minimally invasive surgical procedure, has become an important diagnostic and therapeutic option for ascites of unknown etiology. Aim of the Study: To evaluate the role of laparoscopy in identifying the underlying causes of ascites, assessing its outcomes, and associated complications. Methodology: A prospective descriptive study was conducted at Al Imam Al-Sadiq Teaching Hospital over two years. Fifty patients with ascites of unknown origin underwent laparoscopic evaluation. Samples were collected for cytological and histopathological analysis to determine the final diagnosis. Results: The mean age was 39.7 years, with a male predominance (60%). Most patients (64%) were from rural areas. Hypertension (30%) was the most common comorbidity, followed by diabetes (22%) and cardiovascular disease (18%). A majority (76%) had no history of previous abdominal surgery, and 66% had chronic ascites lasting six months or more. Laparoscopic sampling identified tuberculosis as the most frequent cause (42%), followed by cirrhosis (30%) and malignancies (20%). The average hospital stay was 24.7 hours, and return to normal activity occurred within 7.5 days on average. The overall complication rate was 22%, with port site infections being the most common (14%). Conclusions: Diagnostic laparoscopy is a valuable and reliable method for evaluating unexplained ascites, offering high diagnostic yield with a low complication rate.