二孔腹腔镜肝脓肿引流术(附18例报告)  

Two-port laparoscopic drainage in the treatment of liver abscess: Report of 18 cases

作　　者：杨运芳[1] 聂改红[1] 

机构地区：[1]河南平顶山煤业集团总医院腔镜中心,平顶山467000

出　　处：《中国微创外科杂志》2007年第6期518-519,共2页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的：探讨二孔腹腔镜下肝脓肿引流术的价值。方法：对18例肝脓肿行二孔腹腔镜下切开引流术。脐上缘及右侧肋缘下4～5cm近腋前线处做切口，脓肿表面做“＋”或“＋”形切开，脓腔用剥离棒或吸引器钝性分离分隔，双腔引流管引流。结果18例腹腔镜手术获得成功，手术时间30～75min，平均45min。1例术后出现胆漏，每日80～100ml，术后第12天拔除引流管，第14天出院。术后住院时间7～14d，平均8．5d。18例随访5～12个月，平均9个月，无脓肿残留及复发。结论：二孔腹腔镜下肝脓肿引流术，操作简单、创面周围污染轻、创伤小、术后患者恢复快，值得临床推广。Objective To explore the feasibility of two-port laparoscopic drainage in the treatment of liver abscess. Methods A total of 18 patients with bacterial hepatic abscess underwent two-port laparoscopic drainage. Two incisions were made at the superior border of the umbilicus and 4 ～ 5 cm below the right costal margin near the anterior axillary line, respectively. The abscess was cut through in “＋” or “＋” shape. The pus cavity was debrided bluntly, and a double-lumen drainage tube was placed. Results The laparoscopic drainage was performed successfully in all the 18 patients. The operative duration was 30～75 min （ mean, 45 min）. A bile leakage for 80 ～ 100 ml per day occurred in 1 patient. The drainage tube was removed on the 12th postoperative day and the patient was discharged from hospital on the 14th postoperative day. Of the 18 patients, the hospital stay after operation was 7 ～ 14 d （mean, 8.5 d）. All the patients were followed for 5 ～12 months （mean, 9 months） and no residual abscess or recurrence was found. Conclusions Two-port laparoscopic drainage for liver abscess is an ideal approach with advantages of simple manipulation, slight contamination inside abdominal cavity, little trauma, low complication rates, and rapid recovery.

关 键 词：腹腔镜 肝脓肿 引流术 

分 类 号：R657.33[医药卫生—外科学]