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Role of Laparoscopy in Abdominal Tuberculosis Diagnosis

Figs 2A and B: Intraoperative findings. (A) Mesenteric lymph node biopsy; (B) Parietal wall tubercles

Table 1: Comparison of various methods for the diagnosis of TB with a visual impression
Visual findings AFB Gene
Study group S/o TB AFB staining culture Histopathology TB PCR Xpert
50 42 20 28 38 38 39
Percentage 84 40 56 76 76 78

Table 2: Sensitivity and specificity test
Visual impression Disease No disease Total
Positive True-positive (39) False-positive (3) 42
Negative False-negative (0) True-negative (8) 8
39 11 50

Table 3: Comparison of all tests with laparoscopy
Positive predictive Negative predictive
Sensitivity (%) Specificity (%) value (%) value (%)
AFB staining 51.28 100 100 36.66
AFB culture 59.57 100 100 36.66
Histopathology 97.4 100 100 91.66
TB PCR 97.4 100 100 91.60
Gene Xpert 100 100 100 100
Laparoscopy 100 72 92.85 100

In the last few years, laparoscopy has emerged as a safe and AFB staining is positive in 40% of subjects. The sensitivity and
rapid investigation for the direct visualization of the peritoneal specificity were 51.28 and 100%, respectively. The positive predictive
cavity in cases of suspected abdominal Kochs. Laparoscopy value was 100%, and the negative predictive value was 91.66%.
under general anesthesia permits the observation of the entire AFB culture is positive in 56% of subjects. The sensitivity
peritoneal space and provides tissue samples in targeted areas and specificity were 59.57 and 100%, respectively. The positive
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for histopathology. Few complications during laparoscopy are predictive value was 100%, and the negative predictive value was
reported without any mortality. Thus, laparoscopy can be safely 36.66%.
performed in all patients suspected to have abdominal TB for rapid Histopathology is a very specific method for the diagnosis of
diagnosis rather than relying on conventional methods that may abdominal TB. In our study, (38/50) 78% of the patients who were
take up to 4–6 weeks. diagnosed to have TB had histopathology findings suggestive of TB.
In our study, we have made an attempt to find the efficacy of The association was statistically significant (p <0.05). The sensitivity
diagnostic laparoscopy in abdominal TB. We have compared visual of the test was 97.4%, and the specificity was 100%. The positive
impression during laparoscopy with different tests like AFB stain, predictive value was 100%, and the negative predictive value was
AFB culture, histopathology, TB PCR, and Gene Xpert. 91.66%.

World Journal of Laparoscopic Surgery, Volume 14 Issue 3 (September–December 2021) 147