巨大肝包虫囊肿的保留器官手术治疗
Organ-sparing surgical treatment of giant hepatic hydatid cysts.
作者信息
Losanoff Julian E, Richman Bruce W, Jones James W
机构信息
Department of Surgery, M580 Health Sciences Center, University of Missouri-Columbia School of Medicine, One Hospital Dr., Columbia, MO 65212, USA.
出版信息
Am J Surg. 2004 Feb;187(2):288-90. doi: 10.1016/j.amjsurg.2003.11.026.
BACKGROUND
Excision of giant hepatic hydatid cysts may be associated with loss of hepatic tissue. We describe a method for obliterating spacious residual cavities that promotes salvage of healthy liver parenchyma.
METHODS
After simple cystectomy, the residual cavity is obliterated by manual compression of the healthy liver parenchyma from the left and right toward the midline of the cavity. While compression is maintained, the approximated edges of the cyst's fibrous capsule are closed with mattress sutures. Omentoplasty or gelatine sponges are used to fill the dead space prior to suturing of the fibrous capsule.
RESULTS
The method was used in 8 patients between 1993 and 2000. No sepsis, postoperative bile leak, or other complications occurred. No long-term adverse effects were found.
CONCLUSIONS
This method is simple and effective for obliteration of extremely large residual cavities after cystectomy for liver hydatidosis. It may be used safely in selected patients.
背景
巨大肝包虫囊肿切除可能会导致肝组织缺失。我们描述了一种闭塞宽敞残余腔隙的方法，该方法可促进健康肝实质的保留。
方法
单纯囊肿切除术后，通过从左右两侧向腔隙中线手动挤压健康肝实质来闭塞残余腔隙。在保持挤压的同时，用褥式缝线缝合囊肿纤维囊的近似边缘。在缝合纤维囊之前，使用网膜成形术或明胶海绵填充死腔。
结果
1993年至2000年间，该方法应用于8例患者。未发生脓毒症、术后胆漏或其他并发症。未发现长期不良反应。
结论
该方法对于肝包虫病囊肿切除术后极大残余腔隙的闭塞简单有效。在选定患者中可安全使用。
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