[Laparoscopy in the diagnosis and differential diagnosis of ascites].

Out of 2,500 patients who underwent laparoscopy 772 (30.89%) had ascites; liver cirrhosis underlay it in 57.78%, peritoneal carcinosis in 26.29%, primary and metastatic carcinoma, respectively, in 12.95%, tuberculous peritonitis in 1.42%, more rarely other diseases. Liver cirrhosis, malignant tumours and the other hepatic affections with concomitant ascites in their course can certainly be diagnosed laparoscopically. Laparoscopy with oriented biopsy of peritoneum and liver is of decisive importance in differentiating peritoneal carcinosis from tuberculosis. In peritoneal carcinosis the diagnosis (as based in clinical and laboratory findings) coincided perfectly with the laparoscopic and histologic one in 24.5%, partially in 45.5%. In 30% there was no congruence at all. Laparoscopy and the test methods associated with it contributed to the accurate diagnosis of peritoneal carcinosis in 75.5% of the patients. Ovarian carcinoma (20.9%) and cancer of the stomach (16.3%) underlay peritoneal carcinosis most frequently, other diseases by far more seldom.