Department of General Surgery, Antoine Béclère Hospital, AP, HP, Clamart, F-92140, France.
Am J Surg. 2010 Jan;199(1):131-5. doi: 10.1016/j.amjsurg.2008.12.027. Epub 2009 Apr 17.
Primary intrahepatic bile duct dilatation (IHBD) may present as a localized form in which resection of the affected liver can prevent immediate and late complications. Laparoscopy has gained large interest in liver surgery. It also allows a safe and efficient exploration of the common bile duct.
We performed 10 laparoscopic liver resections for localized IHBD, on 7 women and 3 men (mean age 47 years). Resections were 2 right hepatectomies, 4 left hepatectomies, and 4 left lateral sectionectomies. Three patients had associated common bile duct stones that were treated through intraoperative cholangioscopy.
The mean operative time was 303.9 minutes. The mean blood loss was 217 mL. None of these patients required hand assistance or conversion to open surgery. One patient suffered a residual collection that was drained percutaneously. The postoperative course was uneventful in the other patients. The mean hospital stay was 5.3 days. No recurrence of cholangitis was observed during the follow-up period.
The laparoscopic treatment of IHBD is safe and should be performed by teams with expertise in both hepatobiliary surgery and laparoscopy.
原发性肝内胆管扩张症（IHBD）可表现为局限性形式，通过切除受影响的肝脏可以预防即刻和迟发性并发症。腹腔镜在肝脏手术中得到了广泛关注。它还可以安全有效地探查胆总管。
我们对 7 名女性和 3 名男性（平均年龄 47 岁）的 10 例局限性 IHBD 进行了腹腔镜肝切除术。切除包括 2 例右半肝切除术、4 例左半肝切除术和 4 例左外侧叶切除术。3 例患者合并胆总管结石，通过术中胆管镜治疗。
平均手术时间为 303.9 分钟，平均失血量为 217ml。这些患者均无需手助或转为开放性手术。1 例患者出现残余积液，经皮引流。其他患者的术后过程均顺利。平均住院时间为 5.3 天。在随访期间未观察到胆管炎复发。
腹腔镜治疗 IHBD 是安全的，应由具有肝胆外科和腹腔镜专长的团队进行。
