BENIGN NON-PARASITIC CYSTS OF THE LIVER: A REVIEW OF 18 CASES

Benign non-parasitic cysts of the liver are a clinical and pathological curiosity except when they cause symptoms or are incorrectly diagnosed as metastases in patients with abdominal malignancy. It is difficult to make a correct diagnosis of benign liver cysts in spite of the armamentarium of modern diagnostic aids available, and on many occasions the diagnosis is made at laparotomy. This is a report of 18 patients with benign cysts of the liver, two of whom suffered complications which we believe have not previously been reported.     

肝部分切除结合囊肿开窗术治疗严重成人多囊肝的疗效分析

目的 探讨肝部分切除结合囊肿开窗术治疗严重成人多囊肝的疗效.方法 回顾性分析近期2例严重成人多囊肝的临床、影像学资料及手术疗效.结果 2例多囊肝采用肝部分切除结合囊肿开窗术治疗术后即时及远期疗效良好.结论 肝部分切除结合囊肿开窗术治疗严重成人多囊肝安全有效,远期疗效好,可作为该类疾病的首选治疗方法.     

复发性肝包虫和残腔积液的外科治疗

目的 减少或消灭肝包虫病术后复发及术后残腔积液等并发症。方法 ８年间手术治疗的３２０例肝包虫中筛选出２８例复发性肝包虫及术后残腔积液者,采用纤维胃镜探查、带蒂大网膜移植充填外囊腔、经皮肝穿刺抽液注入硬化剂,手术前后服抗包虫病药等综合性方法治疗。结果 本组２８例病人中未见包虫复发及残腔积液,治愈率达１００％。结论 上述３种方法对肝包虫病的“非接触手术技术”（ｕｎｔｏｕｃｈａｂｌｅ ｔｅｃｈｎｉｑｕｅ）具有明显的治疗价值。     

TRANSHEPATIC FENESTRATION OF LIVER CYST A FURTHER APPLICATION OF LAPAROSCOPIC SURGERY

Surgery is indicated for the treatment of highly symptomatic liver cysts in adult polycystic liver disease. Several options are available, including liver resection, but surgical morbidity in a benign condition may be unacceptable. The authors report the transhepatic fenestration of a liver cyst under laparoscopic guidance in a 47 year old Chinese male. There was an excellent clinical outcome and minimal morbidity. Laparoscopic treatment is both effective and minimally traumatic, which is appropriate for a condition that will inevitably progress.     

EPIDERMOID CYST OF THE SPLEEN

Epidermoid cysts of the spleen are extremely rare, occurring mainly in people under 20 years of age. They are thought to originate from an abnormality in the development of the spleen during the seventh week of embryological life, when the spleen is close to the mesonephric tissues. Cysts present as an asymptomatic abdominal mass or with pain in the left upper quadrant and/or the left shoulder. In the past the recommended treatment has been splenectomy, but with the changing attitudes towards splenic surgery a more conservative approach is now employed. Drainage under radiographic guidance, deroofing with external drainage or simply deroofing with drainage into the peritoneal cavity are now more popular techniques (along with simple cystectomy). Complications are few, although those associated with deroofing and internal drainage are inadequately investigated.     

MULTILOCULAR CYST OF THE KIDNEY

Four examples of multilocular cyst of the kidney occurring in adult Chinese women are reported. This uncommon lesion has distinctive sonographic and clinicopathological features. The aetiology and pathogenesis are unknown. The differential diagnosis, pre-operative evaluation, and treatment are discussed.     

88例儿童胆总管囊肿肝脏病理临床分析

目的 讨论儿童胆总管囊肿导致肝损害的主要原因、儿童胆汁性肝脏纤维化分级及临床转归。方法 收集88例儿童胆总管囊肿手术时肝活检的病理结果进行临床分析、肝纤维化分级,其中11例因分期手术曾有二次肝活检结果。根据随访及二次肝活检结果对儿童胆汁性肝纤维化的转归进行讨论。结果 88例中术后3例死于肝衰竭,59例获长期随访,恢复好。88例肝纤维化分级为：0级10例、1级42例、2级21例、3级10例、4级5例。其中11例二次肝活检的病例在胆总管囊肿外引流3-8个月后8例肝纤维化程度分别下降1-2级,3例无变化（其中1例为0级）。结论 （1）继发性胆道梗阻是儿童胆总管囊肿导致肝损害的主要原因。（2）建立统一的肝纤维化分级标准有助于临床评判。（3）儿童胆汁性肝纤维化在病因解除后在一定程度上可得到逆转,即使是假小叶形成后仍可能存在一定机会。     

经皮穿刺抽吸囊液和囊内无水酒精注射术治疗巨大非寄生虫性肝囊肿

目的 探讨巨大非寄生虫性肝囊肿的无水酒精注射疗法及其疗效。方法 采用超声普通探头引导下经皮肝穿刺抽吸囊液后注射无水酒精治疗巨大非寄生虫性肝囊肿350例，囊肿直径均在10cm以上，共350个囊肿病灶，最大囊肿直径为25．5cm，平均治疗4—5次，单个囊肿一次抽液量最多者为1800m1，累积抽液量最多为5760m1。治疗后超声波检查随访6个月，观察囊肿变化情况，结果 38．6％(135／350)患者囊肿消失，61．4％(215／350)患者囊肿显著缩小，共治疗1552次，未发生严重发症。结论 本方法具有适应症广，创伤小，副作用少，疗效好，经济负担小，患者易于接受等优点。     

ANGIOMYOLIPOMA OF THE LIVER

Hepatic angiomyolipoma is a rare tumour of the liver. Its behaviour is benign and this paper reports the first case described in Australia. A review of the literature suggests that the use of ultrasonography, computerized tomography and angiography should enable pre-operative diagnosis to be made with relative certainty, yet the difficulties with histological diagnosis, particularly on needle biopsy, may necessitate resection.     

体外肝脏切除术对肝脏功能和结构的影响

方法:正常家猪13头，在体外静脉转流和4℃EuroCollins液持续灌注肝脏下行体外肝切除及自体残肝原位再植术。在手术中不同时相点检测肝组织能荷水平（EC）、线粒体呼吸活性（RCR）、动脉血酮体比值（AKBR）和肝脏病理变化。结果：在肝脏冷灌注时相，两组动物肝组织ATP、EC及AKBR水平较术前显著降低，RCR轻度降低。残肝植入后，术程平稳的6头动物，EC水平回升、RCR无显著变化、AKBR回升到0．7以上；术程不平稳的7头动物，RCR下降、EC进一步降低、AKBR仍低于0．5。冷灌注时肝脏组织结构基本保持完整，残肝再植复流后肝组织出现以肝腺泡第Ⅲ带为著的组织损害。结论：体外肝切除术造成肝脏损害的主要原因是再灌流损害；肝细胞能量代谢状态与手术动物的预后密切相关。     

AN EPITHELIAL CYST OF THE SUPRASELLAR REGION

A case of a 26 year old woman with increasing headaches due to a suprasellar cyst is described. Histology was consistent with an epithelial cyst with features resembling both Rathke's cleft cysts and enterogenous cysts. The differential diagnosis and treatment of suprasellar cysts is discussed.