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腹腔镜引流作为复杂性化脓性肝脓肿的一线治疗方法

Laparoscopic Drainage as First Line Treatment for Complex Pyogenic Liver Abscesses.

作者信息

Cioffi Luigi, Belli Andrea, Limongelli Paolo, Russo Gianluca, Arnold Moritz, D'Agostino Alberto, Fantini Corrado, Belli Giulio

出版信息

Hepatogastroenterology. 2014 May;61(131):771-5.

Abstract

UNLABELLED

Background/aims: Pyogenic liver abscess (PLA) is a rare but potentially fatal condition if untreated. In available retrospective series successful rate of per- cutaneous drainage (PD) on large multiloculated PLA, that has been definited "complex". In this observation- al study, we report the experience of our Institution in performing laparoscopic drainage of complex liver ab- scess over a 5-years period as first line treatment for selected cases of PLA. Methodology: All cases of large multiloculated liver abscesses admitted to the General and Hepatobiliary Surgery of "Loreto Nuovo" Hospital Naples, Italy over the last 5-years period were treated by laparoscopic drainage and his clinicopathological variables were retrospectively reviewed.

RESULTS

Ten patients with large multiloculated liver abscess has been admitted and treated by only laparoscopic drainage without need of other perioperative procedures. Mean age was 51.5 years (range 41-75y); average hospital stay was 4.6 days (range 2-6 days) and major postoperative morbidity or deaths were not registered. Successful rate was 100% with no recurrence at 2-years follow up (range 12/38 months).

CONCLUSIONS

Laparoscopic drainage seems to be a safe and reproducible mini-invasive treatment of complex liver abscesses and to offer advantages over percutaneous and surgical open approach.

摘要

未标注

背景/目的:化脓性肝脓肿(PLA)虽罕见,但如不治疗可能致命。在现有回顾性系列研究中,经皮引流(PD)对大型多房性PLA(已被定义为“复杂型”)的成功率[未提及具体成功率数值]。在本观察性研究中,我们报告了我们机构在5年期间对复杂肝脓肿进行腹腔镜引流作为部分选定PLA病例一线治疗的经验。方法:回顾性分析意大利那不勒斯“洛雷托·诺沃”医院普通外科和肝胆外科在过去5年收治的所有大型多房性肝脓肿病例,这些病例均采用腹腔镜引流治疗,并对其临床病理变量进行回顾。

结果

10例大型多房性肝脓肿患者仅通过腹腔镜引流治疗,无需其他围手术期操作。平均年龄为51.5岁(范围41 - 75岁);平均住院时间为4.6天(范围2 - 6天),未记录到严重术后并发症或死亡病例。成功率为100%,在2年随访(范围12/38个月)时无复发。

结论

腹腔镜引流似乎是一种安全且可重复的复杂肝脓肿微创治疗方法,与经皮和手术开放方法相比具有优势。

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