巨大非寄生虫性肝囊肿内引流失败

Internal drainage failure of nonparasitical gigantic hepatic cyst

[背景 ]非寄生虫性肝囊肿是无症状小囊肿 ,无需治疗 ,有压迫症状或出现并发症者 ,应采用手术治疗 .[病例报告 ]1999年 4月行巨大非寄生虫性肝囊肿内引流术 1例 ,术后因内引流不畅、肠内容物反流淤积 ,内引流术失败 .进行第二次手术时利用粗大胶皮引流管行体外引流术 ,术后近 4周囊肿闭缩治愈 .[讨论 ]非寄生虫性肝囊肿通常术式有囊肿开窗术、切除术、内引流术等 .内引流术适用于囊肿体积较大、切除困难者及囊液含有胆汁者 ,该术式基本要求为吻合口要大、位置要低、Y臂长 30～ 6 0cm .本病例吻合口较小且Y臂短 。

BACKGROUND Nonparasitical hepatic cyst is no necessary to treat small cyst with symptomless, but must be operated for those with oppression symptom or complications. CASE REPORT A nonparasitical gigantic hepatic cyst was treated with internal drainage in Apr. 1999, but it was failed because of insufficient drainage, intestinal content reflux and retention. Then it was undergone by extracoporeal drainage with bulky colloid drainage tube and cyst was atresia and healing within 4 weeks. DISCUSSION The operative method of nonparasitical hepatic cyst comprised fenestration, resection, drainage and so on. Drainage was indicated for bulkier cyst that was difficult to excise, and for hydrated fluid containing bile. The basic request of this approach were bigger stoma, lower position, and Y arm length 30～60cm. The failure of this case is due to small stoma and short Y arm length.