The role of laparoscopy in chronic abdominal pain

Abstract

Background-The objective of the study were to study the clinical spectrum of patients of chronic abdominal pain, role of laparoscopy in diagnosis of such patients and to study the impact of diagnostic laparoscopy on the management of chronic abdominal pain. Methodology- This study was conducted as a prospective interventional study on all patients of chronic abdominal pain admitted in General Surgery department of tertiary care center on patients with chronic abdominal pain with uncertain diagnosis. Laparoscopy was conducted in all the cases and diagnosis based on laparoscopy findings, histopathological examination or peritoneal fluid cytological findings were noted, treatment and its impact on outcome was studied. Results-Tuberculosis was the diagnosis in 45 (62.5%) cases whereas in 22 (30.6%) cases, chronic abdominal pain was secondary to malignancy and in 5 (6.9%) cases couldn’t make any diagnosis. Lymph node biopsy, histopathology, ascitic analysis were helpful in making diagnosis and significantly associated with final diagnosis. CA-125 was observed to be significantly associated with malignancy (31.8%) (p<0.05). Unnecessary surgical procedure and laparotomy could be avoided in cases with malignancy and in those cases where diagnosis couldn’t be made and these cases were referred to higher center for further management. Conclusion- Diagnostic laparoscopy is safe and minimally invasive method which not only provide the diagnostic benefit but is helpful in management of patients with chronic abdominal pain. Diagnostic laparoscopy can reduce the requirement of unnecessary laparotomies and its adverse effects. This procedure is effective in definitive diagnosis of patients with chronic abdominal pain. Also it is helpful in obtaining pathological specimen for further analysis. This method is effective in diagnosis of tuberculosis and differentiating tubercular etiology from malignant causes.