腹腔镜手术治疗肝包虫病的体会

Experience of laparoscopic operation in treatment of hepatic echinococcosis

目的：总结腹腔镜手术治疗肝包虫病的手术经验、可行性及安全性。方法：回顾分析65例肝包虫病患者行腹腔镜手术的临床资料,术中于镜下摘除肝包虫内囊、处理残腔、切除外囊,部分患者行肝部分切除术。结果：4例中转开腹,61例手术获得成功;手术时间60-180 min,平均（106±38）min;总住院时间6-35 d,平均（10.3±3.8）d;术后住院5-20 d,平均（7.3±3.2）d。术后5例发生胆漏,2例1年后复发,无腹腔种植。结论：严格选择手术适应证,根据患者情况灵活选择处理方式,并由经验丰富的腹腔镜医师施术,腹腔镜手术治疗肝包虫病是安全、可行的。

Objective： To summarize the clinical experience and investigate the feasibility and safety of laparoscopic operation in the treatment of hepatic echinococcosis. Methods： The clinical data of 65 patients with hepatic marginal echinococcosis who underwent laparoscopic operation were retrospectively analyzed,including laparoscopic excision of hepatic hydatid internal capsule,treatment of residual cavity,excision of hepatic hydatid external capsule and some patients underwent partial hepatectomy. Results： All cases were successfully performed laparoscopic surgery except four were converted to laparotomy. Mean operation time was（ 106 ± 38） min（ range,60-180 min）. Total hospital stay was 6-35 d [mean（ 10. 3 ± 3. 8） d]. Postoperative hospital stay was 5-20 d with a mean of（ 7. 3 ±3. 2） d,5 cases of bile leakage occurred. Two patients recurred in one year after operation,no abdominal cavity plantation was found.Conclusions： Laparoscopic surgery in the treatment of hepatic echinococcosis is a safe and feasible procedure,on the basis of strict selection of indication,flexible choice of approach and experienced laparoscopic surgeons.