Assessment of lipid profile of peritoneal fluid for differential ascites diagnostics

The problem of differential ascites diagnostics in different patients remains urgent for modern surgery. Apart from well known methods, authors propose an original algorithm for assessment of ascetic fluid. The main element of such studies is the determination of a lipid spectrum of ascetic fluid and content of lipid components in cell structures. 260 samples were examined which were obtained from patients having examination and treatment in the General Surgery Clinic of the Kirov Military Medical Academy (St. Petersburg). For examination of ascetic fluid, the methods of cytological analysis of ascitic fluid centrifugate were used, its cytochemical examination, as well a complex of biochemical methods: determination of the total protein, amylase, chylomicrons, triglycerides; bacterial inoculation was made. It has been shown that the ratio of chylomicrons, lipoproteins and cytosis permits a more precise differentiation of ascites type which influences the selection of further treatment program especially in chyloperitoneum and lymphatic ascites.