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巨大肝包虫囊肿的腹腔镜根治性囊肿切除术

Radical Laparoscopic Pericystectomy of a Giant Hepatic Hydatid Cyst.

作者信息

Sotomayor Camila, Reyes Natalia, Briceño Eduardo, Dib Martín, Viñuela Eduardo, Martínez Jorge, Jarufe Nicolás

机构信息

Department of Hepatobiliary Surgery, Pontificia Universidad Católica de Chile, Santiago, CHL.

出版信息

Cureus. 2024 Oct 17;16(10):e71674. doi: 10.7759/cureus.71674. eCollection 2024 Oct.

Abstract

Hydatidosis is an endemic zoonotic disease with an uneven geographical distribution due to the varying abundance of its intermediate hosts, primarily cattle, and sheep in different regions, leading to a higher concentration of cases in livestock areas. Despite advancements in medical treatment and interventional radiology, surgery remains the treatment of choice for patients with hepatic hydatid cysts (HHC). Over the past decade, laparoscopic management of HHC has gained popularity; however, controversies persist regarding optimal patient selection, surgical techniques, and follow-up protocols. Conservative techniques, including capitonnage, partial cystectomy, puncture, and aspiration, have been described, while radical approaches such as pericystectomy and liver resection demonstrate superior management of the residual cavity and reduced recurrence rates. We present the case of a 52-year-old male presenting with right hypochondriac abdominal pain, whose CT scan revealed a giant, uncomplicated hepatic hydatid cyst in the right lobe. The video demonstrates a radical approach using subtotal pericystectomy for a giant hepatic hydatid cyst (>10 cm) located in the right hepatic lobe. The patient had an uneventful recovery and was discharged without complications on the third postoperative day.

摘要

包虫病是一种地方性人畜共患病,由于其中间宿主(主要是不同地区的牛和羊)数量分布不均,导致其地理分布不均衡,从而使病例在畜牧区更为集中。尽管在医学治疗和介入放射学方面取得了进展,但手术仍然是肝包虫囊肿(HHC)患者的首选治疗方法。在过去十年中,HHC的腹腔镜治疗越来越受欢迎;然而,在最佳患者选择、手术技术和随访方案方面仍存在争议。已经描述了包括缝合法、部分囊肿切除术、穿刺和抽吸在内的保守技术,而诸如囊肿外切除术和肝切除术等根治性方法在残余腔管理方面表现更佳且复发率更低。我们报告一例52岁男性患者,因右季肋部腹痛就诊,其CT扫描显示右叶有一个巨大的、无并发症的肝包虫囊肿。该视频展示了一种根治性方法,即对位于右肝叶的巨大肝包虫囊肿(>10 cm)采用次全囊肿外切除术。患者恢复顺利,术后第三天无并发症出院。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd94/11570875/76aa280b551c/cureus-0016-00000071674-i01.jpg

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