肝囊胞に対する腹腔鏡下天蓋切除術の検討

Laparoscopic deroofing of non-parasitic liver cysts

◆要旨：非寄生虫性肝囊胞は通常無症状であり治療の対象とならないが，臨床症状を有するものや増大傾向にある場合には治療が必要になる．これに対して，近年では腹腔鏡下天蓋切除術が施行されている．今回，筆者らは腹腔鏡下天蓋切除術を施行した6例につき検討した．肝囊胞最大径は平均15cm，有症状が5例，エタノール注入無効が1例であった．平均手術時間は123分で，合併症は認めず，平均在院期間は12日間であった．術後経過平均52か月で再発を認めていない．自験例を含めた腹腔鏡下天蓋切除術の本邦報告56例で術後治療を要する合併症は1例，再発1例と良好な成績を収めている．腹腔鏡下天蓋切除術は根治性と低侵襲性に優れた治療法であると考えられた．

　Benign non-parasitic liver cysts are usually asymptomatic, thus treatment is unnecessary. However, liver cysts with associated abdominal symptoms or those that increase in size should be treated. Laparoscopic deroofing（LD）is being increasingly performed for the treatment of liver cysts. Here, we present 6 patients with liver cysts treated by LD. The average size of the liver cysts was 15 cm. Five of the six patients had abdominal symptoms, and one patient in whom the treatment was ineffective was treated by alcohol sclerotherapy. The average operative time was 123 minutes. LD was performed safely and the average duration of hospital stay following LD was 12 days. No recurrences occurred during the follow-up period of 8-88 months（average, 52 months）. Of 56 patients treated by LD, postoperative complications that required a treatment occurred in 1 patient（bile leakage）and recurrence occurred in 1 patient. These results indicate that LD is a safe and useful method for the treatment of liver cysts.