Ikeda Taro, Okazaki Taro, Manabe Yu, Nakanishi Rintaro, Kagiyama Hiroki, Owada Yoshiyuki, Hosono Masayoshi, Sendo Hiroyoshi
Department of Gastroenterological Surgery, Takatsuki General Hospital, Osaka 569-1192, Japan.
Department of Gastroenterological Surgery, Hyogo Cancer Center, Akashi, Hyogo 673-8558, Japan.
J Surg Case Rep. 2024 Mar 26;2024(3):rjae176. doi: 10.1093/jscr/rjae176. eCollection 2024 Mar.
Previous reports describing laparoscopic deroofing as a management modality for a hepatic cyst with biliary communication remain limited. We present the case of a 76-year-old woman who was monitored for 4 years for a giant hepatic cyst in the right lobe of the liver. She presented to our department with a chief complaint of abdominal distension. Moreover, imaging revealed a 24-cm giant hepatic cyst. During laparoscopic deroofing, minimal bile leakage from the intra-cyst wall was observed, which was laparoscopically closed with sutures. No bile leakage or cyst recurrence was observed 18 months postoperative. This highlights that laparoscopic surgery may be used in managing hepatic cysts with biliary communication. Intraoperative findings may reveal biliary communication, which requires careful observation of the cyst wall after deroofing.
先前将腹腔镜去顶术作为一种治疗与胆管相通的肝囊肿的管理方式的报道仍然有限。我们报告了一例76岁女性患者,其右肝叶巨大肝囊肿已被监测4年。她因腹胀为主诉前来我院就诊。此外,影像学检查发现一个24厘米的巨大肝囊肿。在腹腔镜去顶术中,观察到囊肿内壁有少量胆汁渗漏,通过腹腔镜缝合进行了封闭。术后18个月未观察到胆汁渗漏或囊肿复发。这突出表明腹腔镜手术可用于治疗与胆管相通的肝囊肿。术中发现可能提示胆管相通,去顶术后需要仔细观察囊肿壁。