遗传性多囊肝与单纯性肝脏多发囊肿的外科处理

目的 研究遗传性多囊肝与单纯性肝脏多发囊肿的外科处理与疗效方面的差异。方法对2001年3月～2004年10月我院收治的肝脏多发囊肿病例，进一步鉴别出遗传性与单纯性，分析外科处理与治疗效果方面的差异。结果单纯性肝脏多发囊肿57例，遗传性多囊肝病30例；外科处理上，单纯性肝脏多发囊肿多采取囊肿开窗术（占43．37％），而遗传性多囊肝多采用肝切除联合囊肿开窗术（占50％）；术后并发症发生率遗传性多囊肝显著高于单纯性肝脏多发囊肿（52．38％VS13．95％）。遗传性多囊肝行穿刺抽液术易发生囊内出血（发生率为37．5％）。术后囊肿复发与处理方式明显相关，单纯开窗术与穿刺抽液术复发率较高，分别为38．89％、55．56％。结论采用肝切除联合囊肿开窗术治疗遗传性多囊肝，术后易出现胸腹水等并发症。术后囊肿复发与处理方式相关。

Surgical management for autosomal dominant polycystic liver disease and simple multiple liver cysts

Objecive To analyse the results and complications of surgery for liver polycysts.Methods A retrospective analysis of clinical,operative and follow-up data was carried out for patients with liver polycysts who underwent surgery from March 2001 to October 2004 in our hospital.Results The data included 57 patients with simple multiple liver cysts and 30 autosomal dominant polycystic liver disease.Over 70% of patients underwent operations,including fenestration,resection and combined resection-fenestration.Combined resection-fenestration was carried out for 50% of autosomal dominant polycystic liver diseases and fenestration for 43.37% of simple multiple liver cysts.Morbidity was higher in polycystic liver diseases than that in simple multiple liver cysts(52.38% vs 13.95%).Recurrence of simple fenestration and paracentesis was 38.89% and 55.56%,respectively.Conclusions The post-operative recurrence of cysts is correlated with the mode of management.Combined resection-fenestration is suitable for liver polycysts,including simple multiple liver cysts.