Cappuccino H, Campanile F, Knecht J
Department of Surgery, Monmouth Medical Center, Long Branch, New Jersey 07740.
Surg Laparosc Endosc. 1994 Jun;4(3):234-7.
Hepatic abscess is a serious surgical condition with a mortality rate of up to 63% reported if not adequately treated. Laparotomy and computed tomographic (CT) guidance have been used to drain these collections, each with their own problems. Herein we describe a method of draining laparoscopically a hepatic abscess. A 45-year-old Haitian man presented with night sweats and fevers to 103 degrees F; he was diagnosed by CT to have a large (7 cm) abscess in the posterosuperior portion of the right hepatic lobe. The CT-guided drainage yielded only 8 cc fluid. The patient underwent laparoscopy-guided drainage of the abscess with placement of intra-hepatic and perihepatic drains. The patient had dramatic clinical improvement with no morbidity from the procedure. A follow-up CT of the abdomen revealed near-complete disappearance of the abscess cavity within 48 h. A straightforward method of laparoscopic drainage of hepatic abscesses is presented in detail. It provides a simple alternative for drainage with excellent results and minimal morbidity.
肝脓肿是一种严重的外科病症，若治疗不充分，报告的死亡率高达63%。剖腹手术和计算机断层扫描（CT）引导已用于引流这些积液，但每种方法都有其自身问题。在此我们描述一种通过腹腔镜引流肝脓肿的方法。一名45岁的海地男子出现盗汗和发热，体温高达103华氏度；CT诊断他在右肝叶后上部有一个大（7厘米）脓肿。CT引导下引流仅引出8毫升液体。该患者接受了腹腔镜引导下脓肿引流，并放置了肝内和肝周引流管。患者临床症状显著改善，该手术未导致任何并发症。腹部后续CT显示脓肿腔在48小时内几乎完全消失。本文详细介绍了一种简单直接的腹腔镜引流肝脓肿的方法。它为引流提供了一种简单的替代方法，效果极佳且并发症极少。
