Altinli Ediz, Saribeyoglu Kaya, Pekmezci Salih, Uras Cihan, Tasçi Hasan, Akçal Tarik
University of Istanbul, Cerrahpasa Medical Faculty, Department of Surgery Istanbul, Turkey.
JSLS. 2002 Oct-Dec;6(4):323-6.
The objectives of this study were to investigate the characteristics and outcome of patients with hydatid disease of the liver who were laparoscopically managed at our clinic and to define technical details including an effective method of omentoplasty with helical fasteners.
Between January 1998 and November 2000, 13 patients, mean age 36 years (range 23 to 63 years), with hydatid disease of the liver were considered for laparoscopic surgery in our department. All the patients underwent laparoscopic surgical interventions.
In all patients, laparoscopic cystotomy, unroofing, and omentoplasty with helical fasteners, which were originally designed for endoscopic hernia repair procedures, were performed. No conversion to laparotomy was necessary. In 1 case, with a single cyst in the right lobe, bile leakage was observed. No radiological recurrence was observed in an average follow-up of 17 months (range 4 to 36 months).
Obliteration of the residual cystic cavity decreases postoperative complication rates, so an effective omentoplasty is essential especially for laparoscopic procedures. Laparoscopy is quite feasible to perform in hydatid disease of the liver, and the use of helical fasteners allows effective omental flap fixation.
本研究的目的是调查在我们诊所接受腹腔镜治疗的肝包虫病患者的特征和预后，并确定技术细节，包括使用螺旋紧固件进行大网膜成形术的有效方法。
1998年1月至2000年11月期间，我科对13例平均年龄36岁（23至63岁）的肝包虫病患者进行了腹腔镜手术评估。所有患者均接受了腹腔镜手术干预。
所有患者均进行了腹腔镜囊肿切开术、囊肿去顶术以及使用最初设计用于内镜疝修补手术的螺旋紧固件进行大网膜成形术。无需转为开腹手术。1例右叶单发囊肿患者出现胆汁渗漏。平均随访17个月（4至36个月）未观察到影像学复发。
残余囊肿腔的闭塞可降低术后并发症发生率，因此有效的大网膜成形术至关重要，尤其是对于腹腔镜手术。腹腔镜手术在肝包虫病中非常可行，使用螺旋紧固件可实现有效的大网膜瓣固定。
