HEPATI CCYSTS肝脏囊肿.pptVIP

Hepatic Cysts Introduction The term hepatic cyst usually refers to solitary nonparasitic cysts of the liver, also known as simple cysts. Most simple cysts asymptomatic and require no treatment. When the cysts become large and cause symptoms, treatment is warranted. Today, laparoscopic unroofing（去顶术） of large simple cysts has become the preferred treatment option. History of the Procedure Diagnosis confirmation: an abdominal mass or an incidental finding during laparotomy ultrasonography and computed tomography scans Treatment ：laparotomy laparoscopic approach Frequency: 5% , less than 10-15% symptomatic Classification nonparasitic cysts congenital cysts simple cyst multiple cysts inflammatory cysts cystic tumors traumatic cysts parasitic(echinococcal、棘球蚴) cysts Etiology simple cysts ：unknown, congenital in origin. perhaps progressive dilatation of biliary microhamartomas（微错构瘤）. seldom contain bile？Hypothesis？ polycystic liver disease : congenital echinococcal cysts:infestation with E granulosus. Pathophysiology simple cyst: fluid secretion by the epithelial lining ,needle aspiration ? echinococcal cysts: life history of E granulosus Clinical presentation simple cyst dull right upper quadrant pain, satiety(饱涨感），a palpable abdominal mass polycystic liver disease hepatomegaly , hepatic fibrosis, portal hypertension, and liver failure echinococcal cysts similar to patients with simple cysts. rupture into different sites (the biliary tree, the chest, the peritoneal cavity) ； secondary infection Auxiliary inspection 1、Lab Studies: liver (renal) function test ,PT,KPTT; BR (eosinophilia 嗜红细胞增多) , echinococcal antibody titers 2、Imaging Studies: Ultrasonography Computed tomography MRI Imaging Studies Ultrasound appearance of a patient