Gloor B, Ly Q, Candinas D
Department of Visceral and Transplantation Surgery, University of Bern, Inselspital, CH-3010 Bern, Switzerland.
Dig Surg. 2002;19(6):494-9. doi: 10.1159/000067603.
Hepatic cysts are detected incidentally in 2.5-5% of the population. Only about 15% of such cysts are symptomatic. Since laparoscopic deroofing for liver cysts was first described in 1991 there have been a number of reports of successful laparoscopic management of hepatic cysts, including the laparoscopic management of complex and parasitic cysts.
A systematic review of English-language articles on the subject appearing in journals through May 2002 was conducted using the Medline database.
Only a minority of cystic liver lesions need treatment, and the therapeutic approach is guided by the type of cyst. Laparoscopic deroofing (combined with omentoplasty and/or oversewing) of uncomplicated liver cysts is associated with a recurrence rate of 10-25%, with less morbidity and mortality as compared to open surgery. On the other hand, treatment of complex liver cysts and hydatid cysts by laparoscopy is not considered a standard approach.
The laparoscopic approach in uncomplicated but symptomatic liver cysts is effective, with low morbidity and mortality. Additional omentoplasty or oversewing appears to reduce the recurrence rate.
肝囊肿在2.5%至5%的人群中是偶然发现的。这类囊肿中只有约15%有症状。自1991年首次描述腹腔镜下肝囊肿开窗术以来，已有许多关于成功采用腹腔镜治疗肝囊肿的报道，包括对复杂囊肿和寄生虫性囊肿的腹腔镜治疗。
使用Medline数据库对截至2002年5月发表在期刊上的关于该主题的英文文章进行系统综述。
只有少数肝囊性病变需要治疗，治疗方法取决于囊肿类型。单纯性肝囊肿的腹腔镜开窗术（联合网膜固定术和/或缝合）复发率为10%至25%，与开放手术相比，发病率和死亡率更低。另一方面，腹腔镜治疗复杂肝囊肿和包虫囊肿不被视为标准方法。
腹腔镜治疗单纯性但有症状的肝囊肿有效，发病率和死亡率低。额外的网膜固定术或缝合似乎可降低复发率。
