Sumer Fatih, Kayaalp Cuneyt, Polat Yılmaz, Ertugrul Ismail, Karagul Servet
Department of Surgery, Inonu University , Malatya, Turkey.
Interv Med Appl Sci. 2016 Jun 1;8(2):89-92. doi: 10.1556/1646.8.2016.2.3.
Surgical treatment is often necessary for patients with symptomatic or complicated polycystic liver diseases (PLD). In this paper, we describe a 52-year-old female with symptomatic PLD that had resulted in the formation of liver cysts, the largest of which was 23 cm in diameter. The patient underwent mini-laparoscopic fenestration through 5-mm abdominal trocars. The walls of the cysts were unroofed using a harmonic scalpel. Four thickened rubber-like pieces of specimens (sizes ranged between 9 × 6 × 0.5 cm and 6 × 3 × 0.1 cm) were not suitable for extraction through the 5-mm trocars. A gastrotomy was performed, and the specimens were extracted through the stomach with the help of an endoscope. Transoral removal of the specimens was completed without any complications, and the gastrotomy was closed intracorporeally. The patient was permitted to take fluids on day one, and oral intake was gradually increased. She was discharged on day four and was asymptomatic after two months of follow-up. The combination of mini-laparoscopy and intraoperative endoscopic specimen extraction represented a minimally invasive surgical approach for the treatment of PLD. To the best of our knowledge, this was the first case report of the transoral extraction of a liver specimen.
对于有症状或复杂的多囊性肝病（PLD）患者，手术治疗通常是必要的。在本文中，我们描述了一名52岁有症状PLD的女性，该疾病已导致肝囊肿形成，其中最大的囊肿直径达23厘米。患者通过5毫米腹部套管针接受了迷你腹腔镜开窗术。使用超声刀切除囊肿壁。四块增厚的橡胶样标本（尺寸在9×6×0.5厘米至6×3×0.1厘米之间）不适合通过5毫米套管针取出。于是进行了胃切开术，并在内窥镜帮助下通过胃取出标本。经口取出标本过程顺利，无任何并发症，胃切开术在体内关闭。患者术后第一天允许摄入流食，随后逐渐增加经口摄入量。她在术后第四天出院，随访两个月后无症状。迷你腹腔镜检查与术中内镜标本取出相结合是治疗PLD的一种微创手术方法。据我们所知，这是经口取出肝脏标本的首例病例报告。
