Misra Mahesh C, Khan Rehan N, Bansal Virinder Kumar, Jindal Vikas, Kumar Subodh, Noba Athikho L, Panwar Rajesh, Kumar Atin
Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India.
Surg Laparosc Endosc Percutan Tech. 2010 Feb;20(1):24-6. doi: 10.1097/SLE.0b013e3181cdf3c4.
The greatest disadvantage of conservative surgical procedures in the management of hydatid cyst of the liver is their association with high recurrence rates. Radical surgical procedures such as closed total pericystectomy avoids spillage thereby minimizing recurrences. The use of laparoscopy in performing these radical surgical procedures further reduces the morbidity associated with the open surgery. This study has been carried out to assess the safety and feasibility of laparoscopic pericystectomy in the management of hydatid cyst of liver. Small, peripherally located cysts lying away from major vessels are amenable to laparoscopic pericystectomy successfully whereas, cysts larger than 10 cm, posteriorly located cysts and those lying in close proximity to the major ducts and vessels required conversion owing to bleeding. Therefore, laparoscopic pericystectomy can be regarded as a gold standard for the management of hydatid cyst of the liver in selected patients.
保守性外科手术治疗肝包虫囊肿的最大缺点是复发率高。诸如封闭性全囊肿切除术等根治性外科手术可避免囊液外溢，从而将复发率降至最低。在实施这些根治性外科手术时使用腹腔镜可进一步降低与开放性手术相关的发病率。本研究旨在评估腹腔镜囊肿切除术治疗肝包虫囊肿的安全性和可行性。位于周边、远离主要血管的小囊肿可成功进行腹腔镜囊肿切除术，而直径大于10厘米、位于后部的囊肿以及那些紧邻主要胆管和血管的囊肿则因出血需要转为开放性手术。因此，腹腔镜囊肿切除术可被视为特定患者肝包虫囊肿治疗的金标准。
