Diagnostic gastrointestinal laparoscopy: experience and changing indications.

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.