Evaluation of diagnostic laparoscopy results in Turkish patients with unexplained ascites.

Background: Diagnostic laparoscopy is a minimally invasive surgical method to diagnose intra-abdominal diseases.

Aim: To evaluate patients with unexplained ascites who could not be definitively diagnosed via advanced radiological and endoscopic methods and serological, cytological, and microbiological examinations and, therefore, underwent diagnostic laparoscopy.

Methods: This retrospective analysis evaluated 82 patients who underwent diagnostic laparoscopy due to unexplained ascites. Patients' medical records were obtained from the hospital database. Their age, sex, complaints at admission, laboratory results, radiological imaging results, diagnostic laparoscopy reports, and pathology reports were analyzed.

Results: The serum-ascites albumin gradient was < 1.1 in 96.3% of the patients (n = 79). Among patients, 22 (26.8%) had benign diagnoses and 60 (73.2%) had malignant diagnoses. In addition, 55 (67.1%) were deceased, and the median follow-up time from diagnosis to death was four months. The overall follow-up time ranged from 1 to 142 months, with a median of 14 months. Patients' diagnoses were significantly associated with their survival (P < 0.05, χ ² test). The mortality rate was 86.7% among patients with malignant diagnoses and 13.6% among patients with benign diagnoses.

Conclusion: Diagnostic laparoscopy is minimally invasive, has a low complication rate, and requires a short hospital stay. It can be safely performed to diagnose and treat ascites that remain unexplained after advanced radiological and endoscopic examinations.