腹腔镜开窗引流联合无水乙醇灌注及双极电刀囊壁烧灼治疗肝囊肿  

Laparoscopic fenestration drainage combined with dehydrated alcohol perfusion and bipolar electro-cauterization of cyst wall for hepatic cyst

作　　者：胡健垣 陈焕伟[1] Hu Jianyuan;Chen Huanwei(Department of Hepatobiliary Surgery, the First People's Hospital of Foshan, Foshan 528000, China)

机构地区：[1]广东省佛山市第一人民医院肝脏外科,528000

出　　处：《中华肝脏外科手术学电子杂志》2017年第6期480-483,共4页Chinese Journal of Hepatic Surgery(Electronic Edition)

基　　金：佛山市科技创新项目(2016AB002281)

摘　　要：目的探讨腹腔镜开窗引流联合无水乙醇灌注及双极电刀囊壁烧灼治疗肝囊肿的临床疗效。方法回顾性分析2013年1月至2015年12月在佛山市第一人民医院行腹腔镜开窗引流联合无水乙醇灌注及双极电刀囊壁烧灼治疗的15例肝囊肿患者临床资料。其中男7例,女8例,年龄40~65岁,中位年龄51岁。患者均签署知情同意书,符合医学伦理学规定。肝囊肿患者均采用腹腔镜肝囊肿开窗引流,同时采用无水乙醇灌注和双极电刀烧灼破坏囊壁。观察患者术中及术后情况。结果全部患者均成功完成手术,无中转开腹。手术中位时间60(50~75)min,术中出血量30(15~50)ml,引流囊液量1 450(1 000~2 000)ml。术后拔除引流管时间3(2~4)d,术后住院时间4(3~5)d。术后无发生胆漏、出血并发症。术后1年所有患者复查超声、CT或MRI均无发现复发。结论腹腔镜开窗引流联合无水乙醇灌注及双极电刀囊壁烧灼治疗肝囊肿是一种安全、有效的术式,具有微创、胆漏发生率低、复发率低的优势。Objective To evaluate the clinical efficacy of laparoscopic fenestration drainagecombined with dehydrated alcohol perfusion and bipolar electro-cauterization of cyst wall in treating hepaticcyst.Methods Clinical data of15patients with hepatic cyst undergoing laparoscopic fenestration drainagecombined with dehydrated alcohol perfusion and bipolar electro-cauterization of cyst wall in the First People'sHospital of Foshan between January2013and December2015were retrospectively analyzed.Among them,7patients were male and8were female,aged40-65years with a median age of51years.The informedconsents of all patients were obtained and the local ethical committee approval was received.All the patientsreceived laparoscopic fenestration drainage,dehydrated alcohol perfusion and bipolar electro-cauterizationof cyst wall.Intraoperative and postoperative physical conditions of the patients were observed.ResultsThe surgery was successfully completed in all patients.No conversion to open surgery occured.The medianoperating time was60(50-75)min.The intraoperative hemorrhage volume was30(15-50)ml.The volumeof drainage cystic fluid was1450(1000-2000)ml.The postoperative time of removal of drainage tubewas3(2-4)d.The postoperative length of hospital stay was4(3-5)d.Neither bile leakage nor hemorrhagecomplications occurred after surgery.No recurrence was observed in all patients by ultrasound,CT scan or MRI1year after surgery.Conclusions Laparoscopic fenestration drainage combined with dehydratedalcohol perfusion and bipolar electro-cauterization of cyst wall is a safe and effective way for treating hepaticcyst.It has the advantages of minimally invasion,low incidence of bile leakage and recurrence rate.

关 键 词：引流术 乙醇 双极电刀 肝囊肿 

分 类 号：R657.3[医药卫生—外科学]