Shiozaki Shohei, Akabane Shintaro, Shimomura Manabu, Yano Takuya, Kambara Takahiro, Ohdan Hideki
Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan.
Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan.
Int J Surg Case Rep. 2023 Oct;111:108838. doi: 10.1016/j.ijscr.2023.108838. Epub 2023 Sep 20.
Retroperitoneal pseudocysts of non-pancreatic origin are rare. Although the laparoscopic approach has been used for their treatment, laparotomy remains the mainstream strategy for these lesions.
We report the case of an asymptomatic 51-year-old male patient who was incidentally diagnosed with a retroperitoneal pseudocyst. Computed tomography showed a 3 × 3 cm cystic lesion in the retroperitoneum, localized between the third part of the duodenum and the inferior vena cava. The patient underwent complete laparoscopic excision using a modified right-sided colonic resection procedure (modified medial approach), and histopathological examination revealed a non-pancreatic retroperitoneal pseudocyst. The patient was discharged without any complications, and no postoperative recurrence was detected.
Complete excision is of great significance in the treatment of retroperitoneal cysts. There have been few studies on the laparoscopic approach for retroperitoneal pseudocysts. A laparoscopic procedure is less invasive and helps identify the correct tissue planes to ensure complete resection and prevent inadvertent injury to adjacent vital structures. We detached the retroperitoneal lesion from the duodenum and safely removed it without damaging the surrounding organs by a modified medial approach.
Retroperitoneal pseudocysts can be resected laparoscopically by identifying the correct tissue planes and adjacent vital structures.
非胰腺源性腹膜后假性囊肿罕见。尽管腹腔镜手术已用于其治疗，但剖腹手术仍是这些病变的主流治疗策略。
我们报告一例51岁无症状男性患者，偶然诊断为腹膜后假性囊肿。计算机断层扫描显示腹膜后有一个3×3厘米的囊性病变，位于十二指肠第三部和下腔静脉之间。患者采用改良右侧结肠切除术（改良内侧入路）进行了完全腹腔镜切除，组织病理学检查显示为非胰腺源性腹膜后假性囊肿。患者无并发症出院，未发现术后复发。
完全切除对腹膜后囊肿的治疗具有重要意义。关于腹腔镜治疗腹膜后假性囊肿的研究较少。腹腔镜手术创伤较小，有助于识别正确的组织层面，以确保完全切除并防止意外损伤相邻重要结构。我们通过改良内侧入路将腹膜后病变与十二指肠分离，并安全切除，未损伤周围器官。
通过识别正确的组织层面和相邻重要结构，腹膜后假性囊肿可通过腹腔镜切除。
