Wabitsch Simon, Schoening Wenzel, Bellingrath Julia-Sophia, Brenzing Christian, Arnold Alexander, Fehrenbach Uli, Schmelzle Moritz, Pratschke Johann
Department of Surgery, Charité - Universitätsmedizin Berlin, Campus Charité Mitte and Campus Virchow-Klinikum, Berlin, Germany.
Department of Pathology, Charité - Universitätsmedizin Berlin, Campus Charité Mitte and Campus Virchow-Klinikum, Berlin, Germany.
J Minim Access Surg. 2021 Jan-Mar;17(1):63-68. doi: 10.4103/jmas.JMAS_177_19.
Liver resection is the treatment of choice for patients with localised Caroli disease. While liver resection was traditionally performed as open procedure, this case series aims to evaluate the safety and efficacy of minimally invasive, laparoscopic liver surgery in these patients.
A systematic review of electronic case files of patients seen between April 2015 and December 2017 at the Department of Surgery, Charité University Hospital Berlin, was conducted. Patients with Caroli disease in whom laparoscopic liver resection had been performed were identified and analysed in this single-centre case series.
Seven patients who underwent laparoscopic liver surgery for Caroli syndrome were identified and presented with a median age of 49 (range = 44-66) years, of which four (57%) were female. Preoperatively, six patients were classified as the American Society of Anaesthesiologists (ASA) 2 and one patient as ASA 3. Two operations were performed as single-incision laparoscopic surgery, whereas the others were done as multi-incision laparoscopic surgery. One patient required a conversion to an open procedure. The length of operation varied between patients, ranging from 128 to 758 min (median = 355). The length of stay in the intensive care unit ranged from 0 to 2 days. Two patients presented with post-operative complications (Clavien-Dindo Grade ≥3a), whereas no patient died. In histopathological analysis, all patients demonstrated characteristic findings of Caroli disease and no cholangiocarcinoma was found.
These results indicate that minimally invasive, laparoscopic liver surgery is a safe and efficacious treatment option for patients with Caroli disease who require liver resection.
肝切除术是局限性卡罗利病患者的首选治疗方法。虽然传统上肝切除术是通过开放手术进行的，但本病例系列旨在评估微创腹腔镜肝手术在这些患者中的安全性和有效性。
对2015年4月至2017年12月期间在柏林夏里特大学医院外科就诊的患者电子病历进行系统回顾。在这个单中心病例系列中，对接受腹腔镜肝切除术的卡罗利病患者进行了识别和分析。
确定了7例因卡罗利综合征接受腹腔镜肝手术的患者，中位年龄为49岁（范围=44-66岁），其中4例（57%）为女性。术前，6例患者被分类为美国麻醉医师协会（ASA）2级，1例患者为ASA 3级。2例手术采用单切口腹腔镜手术，其余采用多切口腹腔镜手术。1例患者需要转为开放手术。手术时间因患者而异，范围为128至758分钟（中位时间=355分钟）。重症监护病房的住院时间为0至2天。2例患者出现术后并发症（Clavien-Dindo分级≥3a），但无患者死亡。在组织病理学分析中，所有患者均表现出卡罗利病的特征性表现，未发现胆管癌。
这些结果表明，微创腹腔镜肝手术对于需要肝切除的卡罗利病患者是一种安全有效的治疗选择。
