腹腔镜治疗先天性肝囊肿48例的临床经验与分析

Clinical experiences of laparoscopic treatment for hepatic cyst （48 cases）

目的 探讨腹腔镜治疗先天性肝囊肿的手术操作要点和临床价值.方法 回顾性分析扬州大学临床医学院2006年8月-2009年4月对48例肝囊肿施行腹腔镜治疗,其中开窗术46例,左半肝切除术2例;单发肝囊肿41例,多发肝囊肿7例.结果 48例手术均获成功,无中转开腹,术后无一例胆漏、出血.除左半肝切除术,手术时间均为30～96min,平均45 min;出血量10～90 mL,平均26 mL;住院时间3～9 d,平均5 d;术后随访6～36个月,平均32个月.复发2例.结论 丰富的经验与合理妥善的手术操作规范是避免术后复发及并发症的关键.腹腔镜治疗肝囊肿是安全可行的,具有创伤少、恢复快的特点.

Objective To explore the operative main point and clinical effects of laparoscopic treatment for hepatic cyst. Methods Between August 2006 and April 2009, Forty-eight cases of laparoscopic treatment for hepatic cyst were performed, and the data were analyzed retrospectively. Of these treatments, there were laparoscopic fenestration （46 cases） and laparoscopic anatomical resection of left hepatic lobe （2 cases）. Of the patients, there were solitary cyst （41 cases） and multiple cyst （7 cases）. Results Fortyeight cases all performed laparoscopic treatment successfully. There were no converting to open operation, no biliary leakage and no bleeding. Except for resection of left hepatic lobe, the operating time was 30 -96 minutes （mean, 45 minutes）, the intraoperative blood loss was 10 -90 mL （mean, 26 mL） and the postoperative hospital stay was 3 - 9 days （mean, 5 days）. All the 48 patients were followed up for 6 to 36 months （mean, 32 months）, 2 cases were found recurrence. Conclusions Affluent experience and proper standard of operation are key points for avoiding recurrence and complication in laparoscopic treatment for hepatic cyst. Laparoscopic treatment for hepatic cyst is safe, characterized by less pain and rapid recovery.