Objective To investigate the minimally invasive surgery in the treatment of huge hepatic cyst and its therapeutic effect. Methods A total of 36 patients with huge hepatic cysts admitted to Bethune International Peace Hospital of PLA from January 2007 to January 2013 were treated with ultrasound-guided percutaneous puncture catheter drainage (UG-TPPCD),anhydrous ethanol lavage and laparoscopic omental packing. Its therapeutic effect and adverse reactions were observed. Results The clinical symptoms of 36 cases subsided,and hepatic function of 6 cases with hepatic dysfunction restored to normal after treatment with liver-protecting drugs. At 12 months after the surgery,ultrasonography revealed that huge cyst(21 cm in diameter) of the liver right lobe in 1 patient was reduced to 4 cm,whereas that (≥20 cm in diameter) of the other 6 cases all disappeared. The cure rates in 3,6 and 12 months follow-up were 77.8% (28/36),94.4% (34/36) and 97.2% (35/36) respectively,with a total effective rate of 100%. During the treatment and 12-month follow-up, there were no serious complications such as hemor-rhage,infection and biliary tract injury. Conclusion Anhydrous ethanol lavage method and laparoscopic omental packing are very effective and safe methods in the treatment of huge hepatic cysts.%目的 观察无水乙醇灌洗并腹腔镜开窗大网膜填塞术治疗巨大肝囊肿的临床效果.方法 对2007年1月—2013年1月解放军白求恩国际和平医院收治的巨大肝囊肿36例采用超声引导下经皮肝囊肿穿刺置管引流,无水乙醇灌洗并腹腔镜开窗大网膜填塞术进行治疗,观察其临床疗效和不良反应发生情况.结果 本组经治疗后临床症状均消失,肝功能异常6例治疗期间应用保肝药物进行治疗,术后肝功能均恢复正常;肝右后叶巨大囊肿(囊肿直径21 cm)1例术后12个月复查超声囊腔缩小至4 cm,余肝囊肿≥20 cm 6例术后12个月复查超声囊肿均消失.术后3、6和12个月随访,本组治愈率分别为77.8%(28/36)、94.4% (34/36)、97.2%(35/36),总有效率均为100%.治疗及随访期间本组无一例发生出血、感染及胆道受损等严重并发症.结论 无水乙醇灌洗并腹腔镜开窗大网膜填塞术治疗巨大肝囊肿效果确切且安全性较高.
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