Abstract:
Introduction. Bacterial infections in cirrhotic patients represent a major clinical problem, occuring 4-5 times more frequently
compared to the general population and increasing mortality by leading to acute on chronic liver failure, subsequent
decompensation, and multiorgan failure. The study’s purpose is to determine the possibilities of laparoscopy in the
treatment of spontaneous bacterial peritonitis with decompensated liver cirrhosis.
Materials and methods. A retrospective descriptive study was conducted on 82 patients diagnosed with liver cirrhosis
and spontaneous bacterial peritonitis, who were admitted to the Constantin Tibirna Surgery department No2, Holy Trinity
Municipal Clinical Hospital and the Scientific Research Laboratory of Hepatic Surgery, Nicolae Testemițanu State University
of Medicine and Pharmacy, Chisinau, Republic of Moldova, between January 2012 and December 2021. Patients who
underwent surgical drainage of the abdominal cavity by laparoscopy with postoperative peritoneal lavage with antibiotics
were selected. All patients received standard treatment for the correction of liver function and complications of portal
hypertension. The data were extracted from the medical records of the hospital archive, and the patient database was compiled.
Data analysis was performed using simple statistical calculations.
Results. Positive ascitic fluid bacterial culture was in 29.2% (24 patients), while 70.7% (58 patients) had culture-negative
ascites and peritonitis. The most frequent bacterial species was E. coli, present in 54.1% (13 patients). Mortality was 8.5%
(7 patients) due to progressive liver failure. Recurrence of ascites and peritonitis at 1 month was 6.0% (5 patients).
Conclusions. The laparoscopic approach in spontaneous bacterial peritonitis in patients with decompensated liver cirrhosis
allows for better sanitation of the abdominal cavity, improves peritoneal absorption, and deserves establishment as
clinical practice for patients with ascites and peritonitis and cirrhosis.
