肝囊肿腹腔镜开窗术后再次手术原因分析

目的了解肝囊肿腹腔镜开窗引流术后再次手术的原因，以便总结经验，降低肝囊肿的复发率。方法回顾性总结分析笔者所在医院79例肝囊肿腹腔镜下开窗引流术的临床资料。结果79例患者随访1～5年，11例因复发再次手术。其中：2例为单囊多房性囊肿，术中遗留有深部小囊肿而导致复发；2例由于多发肝囊肿，囊肿之间的透明隔未予切开而复发；2例囊壁处理不当复发而再次手术；2例位于肝后部（Ⅵ-Ⅷ段）位置特殊，操作困难、手术不彻底而复发；3例由于引流开窗过小而复发；总共复发再次手术所占比例为13．4％。结论单囊多房性囊肿、多发肝囊肿、囊肿开窗过小以及膈肌易粘连闭合是导致复发再次手术的主要原因。

Laparoscopic fenestration of liver cysts reoperation analysis

Objective Laparoscopic fenestration of liver cyst drainage after reoperation reasons in order to sum up experience, to reduce the relapse rate of liver cyst. Methods In our hospital were retrospectively analyzed 79 cases of laparoscopic fenestration of liver cyst drainage surgery clinical data. ResuLts 79 cases were followed up 1 to 5 years, 11 cases of reoperation because of recurrence. Of which ： two cases of a single cyst multilocular cyst, surgery left a deep result of a small cyst recurrence; two cases because of multiple liver cysts, cysts were not cut between the septum pellucidum which recurrence ; two cases of cyst recurrence of improper handling The re - operation ; two cases of the liver is located in the rear （ Ⅵ -Ⅶ above） in a unique position, operating difficulties, surgery is not thoroughly and relapse; three cases of fenestration due to drainage is too small and the recurrence; the proportion of total recurrent reoperation 13.4%. Conclusion One capsule multilocular cyst, multiple hepatic cysts, cysts fenestration is too small, and easy adhesion of the diaphragm closure led to recurrence of the main reasons for reoperation.