Objective:To assess the value of laparoscopic exploration in the diagnosis of agnogenic ascites. Methods:The clinical data of 35 patients with agnogenic ascites undergoing diagnostic laparoscopic abdominal exploration and biopsy from Jan. 2005 to Dec. 2010 were retrospectively analyzed. Results: All operations were successfully performed. The mean blood loss was 10 ml and the median operative time was 23 min. No obvious postoperative complications occurred. The etiological factors of 34 cases were identified by pathologic diagnosis and immunohistochemisUy. The total definite diagnostic rate was 97.1%. Of 34 patients,20 cases were tuberculous peritonitis, 12 cases were abdominal cavity malignant tumor (4 cases of peritoneal mesothelioma,4 cases of metastatic adenoma,2 cases of ovarian cancer and 2 cases of lymphoma) ,and 2 cases were cirrhosis of liver. Conclusions: Laparoscopic exploration for agnogenic ascites is safe,efficient,minimally invasive,and with high definite diagnostic rate,but laparoscopic exploration could not replace routine examination.%目的:探讨腹腔镜技术诊治不明原因腹水的应用价值.方法:回顾分析2005年1月至2010年12月为35例不明原因腹水患者行腹腔镜探查活检术的临床资料.结果:35例手术均顺利完成,无手术并发症发生.中位手术时间23 min,平均出血10 ml.经病理、免疫组化检查,确诊34例(确诊率97.1％).结核性腹膜炎20例(57.1％)；腹腔恶性肿瘤12例(34.3％),其中腹膜间皮瘤4例,转移性腺癌4例,卵巢癌2例,淋巴瘤2例；其他3例(8.6％),其中肝硬化2例,未确诊1例.结论:对于不明原因腹水的病因诊断,腹腔镜探查术具有安全、高效、创伤小、确诊率高等优点,应果断行腹腔镜探查术,但腹腔镜探查术并不能代替常规检查.
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