- 期刊
Giant Liver Cysts: Laparoscopic Fenestration vs. Percutaneous Aspiration with Alcohol Sclerosant Therapy
肝巨大囊腫：腹腔鏡開窗術或經皮穿刺吸取合併酒精硬化治療
摘要
肝囊腫是常見的，而且大多數無症狀，但有症狀且巨大之囊腫如需要治療，就有各種治療方法，本研究病例是比較腹腔鏡開窗術(LF)及超音波引導下經皮穿刺吸取及合併酒精注射治療(ENA)來硬化破壞水囊腫之內膜細胞。 病例與方法：在1996至2006年，計有39例（男性15例，女姓24例）診斷爲非寄生蟲性肝囊腫爲本研究迴溯性分析病例，依其影像而大分爲單一囊腫（I-型）有15例(38%)及多數囊腫（Ⅱ-型及Ⅲ-型）有24例(52%)以LF治療者計26例(67%)而13例(33%)以ENA方法治療。 結果：採取LF治療之I-型病例中其體積大小減少大於60%者有8例(73%,8/11)。全體而言，以LF治療及ENA治療兩組其體積減少大於60%分別爲46%(12/26)及32%(4/13)，其P值爲0.565。而症狀再發亦分別爲19%(5/26)及31%(4/13)，其P值爲0.447。 結論：肝囊腫之治療法可選擇LF或ENA，但需依其囊腫數目及位置，一般如囊腫突現在肝表面，則可採取LF爲優先考量，全體而言，兩種方法治療結果在本病例分析是無顯著差異的。
關鍵字
無資料並列摘要
Background: Liver cysts are common and most of them are asymptomatic. Giant and symptomatic cysts can be treated by using various treatment modalities. Comparison of laparoscopic fenestration (LF) and echo-guided needle aspiration (ENA) combined with injection of alcohol as a sclerosant for ablation of the endothelium of the cysts was made in this study. Methods: Between 1996 and 2006, thirty-nine patients (15 males and 24 females) with non-parasitic liver cysts were encountered. A solitary cyst (Type I) was found in 15 patients (38%) and multiple cysts (Type II and III) in 24 patients (52%) based on imaging studies. Laparoscopic cyst fenestration was performed in 26 patients (67%), and 13 patients (33%) underwent percutaneous ENA. Results: Eight of the eleven patients (73%) having a Type I cyst had a more than 60% decrease of cyst size after LF treatments. In total, four out of 13 (31%) ENA patients and 12 out of 26 LF patients (46%) had a 60% decrease in size. There seemed to be some advantage of LF over ENA as regards the decrease of cyst volume, but the difference did not reach the significant level (p=0.565). Symptom recurrence was 19% (5/26) and 31% (4/13) for LF and ENA, respectively (P=0.447) after follow-up studies. Conclusions: The choice of LF or ENA must be based on an evaluation of the type of cystic lesions. The data obtained in this retrospective study allowed us to demonstrate the outcomes in terms of reduction in cyst volume, but the difference between the LF and ENA methods failed to show statistatical significance in this study.