副腎血管腫に対する腹腔鏡下副腎摘出術の1例

Laparoscopic Adrenalectomy for Hemangioma. A Case Report

　胆石症に併存した右副腎血管腫の症例に対して，一期的に右副腎および胆嚢摘出術を施行し，良好な術後経過を得たので報告する．患者は44歳，男性．心窩部痛にて来院．腹部CTにて，胆石症に加えて右副腎に直径2cmの石灰化を有する腫瘤を認めた．手術は腹腔鏡下に施行し，腹腔鏡下胆嚢摘出術と同様に10mmトロッカー4本を腹腔内に挿入し，胆嚢摘出後，後腹膜を切開し右副腎腫瘍を後腹膜腔より剥離後，副腎静脈を二重にクリップし摘出後，ペンローズドレーン2本を腹腔内に挿入した．副腎腫瘍の組織診断はcavernous hemangiomaであったが，術後経過は順調で術後12日目に退院した．近年，副腎摘出術も内視鏡下手術が増加しているが，副腎血管腫に対しても有用であると思われた．

Laparoscopic procedure has been widely used now in several fields of abdominal surgery. We have experienced a case where cholecystectomy and adrenalectomy for hemangioma were performed laparo-scopically at the same time. A 44-year-old male was admitted with a chief complaint of epigastric pain. Abdominal computed tomography revealed gall stones in the gall bladder in addition to a tumor with calcification, 2 cm in diameter, in the right adrenal gland. Cholecystectomy and right adrenalectomy were perfomed simultaneously by laparoscopic procedure through same approach.