Gasim B, Fedail S S, Hakeem S E
National Center for Gastrointestinal and Liver Disease, Ibn Sina Hospital, Faculty of Medicine, University of Khartoum, Khartoum, Sudan.
Trop Gastroenterol. 2002 Apr-Jun;23(2):57-60.
The use of peritoneoscopy is an established method for diagnosis of intra abdominal diseases. In industrialized countries such as USA and Germany its use has declined with the advent of modern imaging techniques. However it is believed that there is an important rationale for its use in developing countries.
A retrospective study to assess the value of peritoneoscopy in a developing country (Sudan).
A total of 274 patients were included in this study. Peritoneoscopy was performed in the endoscopy theatre, using standard techniques. Biopsy specimens were taken, when required, from relevant tissues. The patients were closely monitored during and following the procedure.
Peritoneoscopy was indicated for assessment of hepatomegaly in 108 (39.1%) patients, exudative ascites 66 (24%), diagnosis of abdominal mass 48 (17.5%) and miscellaneous indications 52 (19.4%). The final diagnosis of all cases after peritoneoscopy included malignancies other than hepatocellular carcinoma (HCC) 81 (29.8%) patients, miscellaneous conditions 60 (21.8%), HCC 45 (16.4%), liver cirrhosis 26 (9.4%), abdominal tuberculosis 24 (9.4%), normal liver 16 (5.8%), hepatosplenic schistosomiasis (HSS) 15 (5.5%) and amoebic liver abscess 7 (2.5%). The peritoneoscopic appearance of HSS was very characteristic.
This large study confirms that peritoneoscopy has a high diagnostic yield and is a cost-effective technique for use in developing countries.
腹腔镜检查是诊断腹腔内疾病的一种既定方法。在美国和德国等工业化国家,随着现代成像技术的出现,其使用有所减少。然而,人们认为在发展中国家使用它有重要的理论依据。
一项回顾性研究,以评估腹腔镜检查在一个发展中国家(苏丹)的价值。
本研究共纳入274例患者。在手术室使用标准技术进行腹腔镜检查。必要时从相关组织获取活检标本。在手术期间和术后对患者进行密切监测。
腹腔镜检查用于评估肝肿大的患者有108例(39.1%),渗出性腹水66例(24%),腹部肿块诊断48例(17.5%),其他指征52例(19.4%)。腹腔镜检查后所有病例的最终诊断包括非肝细胞癌(HCC)的恶性肿瘤81例(29.8%)患者,其他病症60例(21.8%),HCC 45例(16.4%),肝硬化26例(9.4%),腹部结核24例(9.4%),肝脏正常16例(5.8%),肝脾血吸虫病(HSS)15例(5.5%),阿米巴肝脓肿7例(2.5%)。HSS的腹腔镜表现非常典型。
这项大型研究证实,腹腔镜检查具有很高的诊断率,是一种在发展中国家使用的具有成本效益的技术。