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

doi:10.3877/cma.j.issn.2095-3232.2017.06.014

中华肝脏外科手术学电子杂志 ›› 2017, Vol. 06 ›› Issue (06) : 480 -483. doi: 10.3877/cma.j.issn.2095-3232.2017.06.014

所属专题：文献；

临床研究

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

胡健垣¹, 陈焕伟¹^,^†(

)

^1. 528000　广东省佛山市第一人民医院肝脏外科

收稿日期:2017-09-10 出版日期:2017-12-10
通信作者: 陈焕伟
基金资助:
佛山市科技创新项目(2016AB002281)

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

Jianyuan Hu¹, Huanwei Chen¹^,^†()

^1. Department of Hepatobiliary Surgery, the First People's Hospital of Foshan, Foshan 528000, China

Received:2017-09-10 Published:2017-12-10
Corresponding author: Huanwei Chen
About author:
Corresponding author: Chen Huanwei, Email: chwei_fsyyy@163.com

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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。

关键词: 引流术, 乙醇, 双极电刀, 肝囊肿

Objective

To evaluate the clinical efficacy of laparoscopic fenestration drainage combined with dehydrated alcohol perfusion and bipolar electro-cauterization of cyst wall in treating hepatic cyst.

Methods

Clinical data of 15 patients with hepatic cyst undergoing laparoscopic fenestration drainage combined with dehydrated alcohol perfusion and bipolar electro-cauterization of cyst wall in the First People's Hospital of Foshan between January 2013 and December 2015 were retrospectively analyzed. Among them, 7 patients were male and 8 were female, aged 40-65 years with a median age of 51 years. The informed consents of all patients were obtained and the local ethical committee approval was received. All the patients received laparoscopic fenestration drainage, dehydrated alcohol perfusion and bipolar electro-cauterization of cyst wall. Intraoperative and postoperative physical conditions of the patients were observed.

Results

The surgery was successfully completed in all patients. No conversion to open surgery occured. The median operating time was 60(50-75) min. The intraoperative hemorrhage volume was 30(15-50) ml. The volume of drainage cystic fluid was 1 450(1 000-2 000) ml. The postoperative time of removal of drainage tube was 3(2-4) d. The postoperative length of hospital stay was 4(3-5) d. Neither bile leakage nor hemorrhage complications occurred after surgery. No recurrence was observed in all patients by ultrasound, CT scan or MRI 1 year after surgery.

Conclusions

Laparoscopic fenestration drainage combined with dehydrated alcohol perfusion and bipolar electro-cauterization of cyst wall is a safe and effective way for treating hepatic cyst. It has the advantages of minimally invasion, low incidence of bile leakage and recurrence rate.

Key words: Drainage, Ethanol, Bipolar electrotome, Hepatic cyst

图1 一例肝囊肿患者手术前后肝脏MRI检查

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