腹腔镜治疗肝囊肿

CLINICAL STUDY ON LAPAROSCOPIC TREATMENT IN HEPATIC CYST

目的探讨应用腹腔镜治疗肝囊肿的手术方法及临床疗效。方法回顾性分析42例腹腔镜治疗肝囊肿的临床资料。结果42例患者手术全部成功,3例(7.1%、3/42)行肝囊肿切除,31例(73.8%、31/42)行肝囊肿开窗引流术,8例(19.1%、8/42)合并胆囊结石行腹腔镜联合手术,无一例中转开腹。手术历时30～100min,平均48min,术中出血量5～65ml,平均20ml,术后住院6～9d,平均7.8d,术后肠功能恢复时间短,有3例使用止痛药,所有患者均痊愈出院。随访病人40例,失访2例,随访率95.2%(40/42),随访时间为6～30个月,平均22个月,术后原症状均消失,随访病人中无肝囊肿复发。结论应用腹腔镜技术治疗肝囊肿具有创伤小、病人恢复快、术后并发症少、住院时间短等优点,是治疗肝囊肿的首选方法。

Objective To explore the surgical methods and clinical efficacy of laparoscopic treatment in hepatic cyst. Methods 42 cases of hepatic cysts were treated with laparoscopic surgery and the clinical data were reviewed. Results The operations were successful in all the cases, 3 cases （ 7. 1% ,3/42 ） received resection of hepatic cyst, 31 cases （73.8% ,31/42 ） were treated with fenestration of hepatic cyst and 8 cases （19. 1% ,8/42） that combined with cholecystolithiasis also received laparoscopie cholccystectomy. No patient was converted to open surgery. The operation time was 30 - 100 min （mean,48 min）, blood loss was 5 -65ml （mean, 20 ml）, and hospital stay was 6 -9 d （mean,7. 8 d） ,the intestine function recovery time was considerably reduced, only 3 patients had anodyne. All the patients were recovered and discharged from hospital. 40 cases were followed-up, lost 2 cases, the follow - up rates were 95.2% （40/42） and the follow -up time was 6 to 30 months （mean,22 months）, the original symptoms had disappeared, no patient was the hepatic cyst recurrence. Conclusions Laparoscopic treatment in hepatic cyst have the advantages of minor invasion, sooner recovery, less complications and shorter hospital stay. The procedure should be the preferable choice for the patients with hepatic cyst.