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目的探讨疑难性腹部疾病诊断性腹腔镜下常见与罕见病变的特征。方法对 31例临床难以诊断的腹痛、腹水和腹块患者进行了电视腹腔镜检查以及窥视下多部位、多点和块状组织活检病理组织学检查。结果① 31例腹腔镜检查均获成功，经活检病理组织学检查 30例明确诊断，确诊率达 96.77％ (30/31)。其中良性病变 17例 (54.84％ )，恶性病变 14例 (45.16％ )，并发现罕见腹部疾病 11例 (35.48％ )(肠系膜淋巴管囊性扩张 1例，腹膜转移性透明细胞癌 2例，腹腔恶性淋巴瘤 3例，腹膜恶性间皮瘤 3例，大网膜恶性间叶肿瘤 1例和腹膜假粘液瘤 1例 )。②本组不同罕见病变各有其特征。结论腹腔镜检查是疑难性腹部疾病 (不明原因腹痛、腹水和腹块 )病因诊断的一种确诊率高、安全、快速的方法，能及时发现罕见病；腹腔镜窥视下块状组织活检可显著提高确诊率，在众多检查中，对疑难性腹部疾病诊断率最高。
Objective To investigate the characteristics of common and rare laparoscopic diagnosis of difficult abdominal diseases. Methods 31 patients with clinically diagnosed abdominal pain, ascites and abdominal mass were examined by laparoscopy and multi-site, multi-site and massive biopsy histopathological examination. Results ① All the 31 cases were successfully diagnosed by laparoscopy. Thirty cases were confirmed by biopsy and histopathology, the diagnosis rate was 96.77% (30/31). Among them, 17 cases (54.84%) were benign and 14 (45.16%) were malignant and 11 cases (35.48%) of rare abdominal diseases were found (1 case of mesenteric lymphatic cystic dilatation, 2 cases of peritoneal metastatic clear cell carcinoma, 3 cases of malignant lymphoma, 3 cases of peritoneal malignant mesothelioma, 1 case of omental malignant mesenchymal tumor and 1 case of peritoneal pseudomyxoma. ② This group of different rare lesions have their own characteristics. Conclusions Laparoscopy is a safe and rapid method for the diagnosis of difficult abdominal diseases (unexplained abdominal pain, ascites and abdominal mass), which can detect rare diseases in time. Laparoscopic biopsy of massive tissues can be significant Improve the diagnosis rate, in many tests, the diagnosis of intractable abdominal disease the highest.