Massoud W Z
Department of Surgery, Cairo University, Egypt.
Int Surg. 1996 Jan-Mar;81(1):9-13.
Many reports have recently shown the feasibility of treating simple cysts, polycystic disease of the liver and biliary cysts by laparoscopy. Groups having experience in this kind of surgery stressed the contraindication to manage hydatid cysts of the liver laparoscopically. This reflects the primary concern regarding the possibility of cyst content spillage. This presentation aims to demonstrate the feasibility and safety of laparoscopic treatment of special types of hepatic hydatid cysts. A 26-year-old female Yemeni patient presented with atypical gall bladder dyspepsia. Abdominal ultrasound only showed chronic calcular cholecystitis. The patient was scheduled for laparoscopic cholecystectomy on the 18th of August 1992. On exploration a globular cyst about 12 cm hanging with a stalk from the under surface of the right lobe of the liver was noticed. The gall bladder was used to elevate the liver. Dissection of the mass from the surrounding structures was achieved. Puncture and suction of the germinal and laminated layers were done. The connecting stalk was doubly ligated with endoloops and cut in between. The patient made an uneventful recovery and was discharged 48 hours later. Hydatid cysts of the liver are dangerous to handle by laparoscopy. However whenever a case is met with where excision can be done, this could be achieved laparoscopically especially in pedunculated cysts. A device of 2 coaxial suckers is presented to procure laparoscopic management of hydatid cysts enough safety against "spillage of contents" as in open surgery.
最近许多报告显示了通过腹腔镜治疗单纯性囊肿、肝多囊病和胆管囊肿的可行性。有这类手术经验的团队强调了腹腔镜处理肝包虫囊肿的禁忌证。这反映了对囊肿内容物溢出可能性的主要担忧。本报告旨在证明腹腔镜治疗特殊类型肝包虫囊肿的可行性和安全性。一名26岁的也门女性患者表现为非典型胆囊消化不良。腹部超声仅显示慢性结石性胆囊炎。该患者于1992年8月18日 scheduled for 腹腔镜胆囊切除术。术中发现一个约12厘米的球形囊肿，从肝右叶下表面以蒂悬吊。利用胆囊抬起肝脏。将肿物与周围结构分离。对生发层和板层进行穿刺抽吸。连接蒂用Endoloop双重结扎并在中间切断。患者恢复顺利，48小时后出院。肝包虫囊肿通过腹腔镜处理有危险。然而，只要遇到可以切除的病例，尤其是有蒂囊肿，就可以通过腹腔镜实现切除。本文介绍了一种双同轴吸盘装置，以在腹腔镜处理肝包虫囊肿时获得与开放手术一样足够安全的“防止内容物溢出”效果。 （注：原文中“scheduled for”直译为“安排进行”，这里意译为“计划进行”使表述更通顺；“procure”直译为“获得”，这里意译为“实现”更符合语境。）
