腹腔镜肝囊(脓)肿开窗引流术30例

30 cases of laparoscopic liver cyst(abscess) fenestration and drainage

目的:探讨腹腔镜肝囊(脓)肿开窗引流术治疗肝囊(脓)肿的优点。方法:收治应用腹腔镜行肝囊(脓)肿开窗引流术患者30例,单发囊(脓)肿13例,多发17例。术前均CT或MR确诊、定位,并排除肝包虫病。应用腹腔镜肝囊(脓)肿开窗引流术进行治疗,分析其临床治疗效果。结果:30例手术均成功,手术时间40~90分钟,平均60分钟。术后24小时均能下床活动。术后48~72小时腹腔引流管无胆汁流出拔除,术后4~7天出院,术后平均住院5天。5例患者同时行腹腔镜胆囊切除术,3例同时行腹腔镜阑尾切除术。术后病理检查均符合肝囊(脓)肿诊断。结论:腹腔镜肝囊(脓)肿开窗引流术具有痛苦小、恢复快等优势,可同时治疗并存的腹部疾病。

Objective:To explore the advantages of laparoscopic liver cyst(abscess) fenestration and drainage in the treatment of liver cyst(abscess).Methods:30 patients treated with laparoscopic liver cyst(abscess) fenestration and drainage were selected,13cases were solitary,17 cases were multiple.Before operation,all patients were diagnosed and located by CT or MR,and hepatic hydatid disease were excluded.All patients were treated with laparoscopic liver cyst(abscess) fenestration and drainage,the clinical therapeutic effect was analyzed.Results:30 cases of operation were all successful,operation time was 40 to 90 minutes,the average was 60 minutes.At 24 hours after operation,all patients were able to ambulate.At 48 to 72 hours after operation,abdominal drainage tube was removed because there was no bile.Patients were discharged from the hospital at 4 to 7 days after operation,average hospitalization time was 5 days.5 cases synchronously underwent laparoscopic cholecystectomy,3 cases synchronously underwent laparoscopic appendectomy.After the operation,pathological examination were consistent with liver cyst(abscess)diagnosis.Conclusion:Laparoscopic liver cyst(abscess) fenestration and drainage has many advantages,such as less pain and faster recovery.It can also treat cofigurative abdominal diseases.