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肝寄生虫囊肿外科治疗的新方法:采用肝脏悬吊法的肝切除术

A new approach to the surgical treatment of parasitic cysts of the liver: Hepatectomy using the liver hanging maneuver.

作者信息

Unal Aydin, Pinar Yazici, Murat Zeytunlu, Murat Kilic, Ahmet Coker

机构信息

Ege University School of Medicine, Department of General Surgery, Izmir 35100, Turkey.

出版信息

World J Gastroenterol. 2007 Jul 28;13(28):3864-7. doi: 10.3748/wjg.v13.i28.3864.

Abstract

AIM

To review 11 patients with parasitic cysts of the liver, who were treated by hepatic lobectomy using the liver hanging maneuver (LHM).

METHODS

Between January 2003 and June 2006, we retrospectively analyzed patients who underwent surgical treatment due to parasitic cysts of the liver, at the Ege University School of Medicine, Department of General Surgery. Of these, the patients who underwent hepatic lobectomy using the LHM were reviewed and evaluated for surgical treatment outcome.

RESULTS

Over a three-year period, there were 102 patients who underwent surgical treatment for parasitic cysts of the liver. Of these, 11 (10%) patients with parasitic cysts of the liver underwent hepatic lobectomy using the LHM. Presenting symptoms were abdominal pain, dyspepsia, and cholangitis. Cyst locations were as follows: right lobe filled with cyst, 7 (63%); segmental location, 2 (18%); and multiple locations, 2 patients (18%). All patients underwent hepatic lobectomy with an anterior approach using the LHM. The intraoperative blood transfusion requirement was one unit for 3 patients and two units for one patient. Postoperative complications included pulmonary atelectasy (2, 18%) and pleural effusion (2, 18%). No significant morbidity or mortality was observed.

CONCLUSION

We concluded that hepatic lobectomy using the LHM should be considered, not only for hepatic tumors or donor hepatectomy, but also to treat parasitic cysts of the liver.

摘要

目的

回顾11例采用肝脏悬吊法(LHM)行肝叶切除术治疗的肝寄生虫囊肿患者。

方法

回顾性分析2003年1月至2006年6月在伊兹密尔艾杰大学医学院普通外科因肝寄生虫囊肿接受手术治疗的患者。其中,对采用LHM行肝叶切除术的患者进行手术治疗结果的回顾与评估。

结果

在三年期间,有102例患者因肝寄生虫囊肿接受手术治疗。其中,11例(10%)肝寄生虫囊肿患者采用LHM行肝叶切除术。主要症状为腹痛、消化不良和胆管炎。囊肿位置如下:右叶充满囊肿7例(63%);节段性位置2例(18%);多个位置2例(18%)。所有患者均采用LHM经前路行肝叶切除术。3例患者术中输血1单位,1例患者输血2单位。术后并发症包括肺不张(2例,18%)和胸腔积液(2例,18%)。未观察到明显的发病率或死亡率。

结论

我们得出结论,LHM肝叶切除术不仅应考虑用于肝肿瘤或供肝切除术,也应用于治疗肝寄生虫囊肿。

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