Rattan J, Fireman Z, Slobodkin D, Hallak A, Rozen P, Gilat T
Department of Gastroenterology, Ichilov Hospital, Tel Aviv Medical Center, Israel.
Isr J Med Sci. 1987 Nov;23(11):1132-6.
We reviewed the records of all 117 patients who underwent diagnostic laparoscopy at our clinic from 1980 to 1985. There were no deaths or marked complications from the procedure. Accurate diagnosis was made in 72% of 79 patients with abdominal pathology; of these, 81% of 63 patients had hepatic pathology, and 44% of 16 patients had extrahepatic pathology. Of 27 patients with conditions that might have justified exploratory laparotomy, diagnosis was made in 48%. Of 29 patients who underwent preceding nondiagnostic blind-needle biopsies of the liver, laparoscopy established a diagnosis of cirrhosis or neoplasm in 44%. A parenthetical finding was that at our institution liver scan alone appeared to be the most adequate imaging workup of suspected hepatic disease. Our data support the use of laparoscopy for diagnosis of hepatic disease and as a first step prior to purely diagnostic laparotomy.
我们回顾了1980年至1985年间在我们诊所接受诊断性腹腔镜检查的117例患者的记录。该手术无死亡或严重并发症。79例有腹部病变的患者中，72%得到了准确诊断；其中，63例有肝脏病变的患者中81%确诊，16例有肝外病变的患者中44%确诊。27例可能需要进行剖腹探查术的患者中，48%得到了诊断。29例之前接受过肝脏非诊断性盲针活检的患者中，腹腔镜检查确诊肝硬化或肿瘤的比例为44%。一个附带的发现是，在我们机构，仅肝脏扫描似乎是对疑似肝脏疾病最充分的影像学检查。我们的数据支持将腹腔镜检查用于肝脏疾病的诊断，并作为单纯诊断性剖腹探查术之前的第一步。
