Application of laparoscopic removal of hepatic hydatid cyst in clinical practice
腹腔镜肝包虫外囊摘除术在临床中的应用

摘要

目的 对比经腹腔镜肝包虫囊外膜完整摘除术与腹腔镜肝包虫内囊摘除术治疗肝包虫病的效果。方法 选取我院2024年1月至2025年10月收治的诊断明确且具有手术指征的40例肝包虫患者作为研究对象，采用前瞻性研究，随机分为对照组和试验组各20例，对照组实施腹腔镜肝包虫内囊摘除术，试验组实施经腹腔镜肝包虫囊外膜完整摘除术，比较两组患者手术时间、术中出血量、并发症发生率。结果 两组手术时间对比差异性无统计学意义（P＞0.05）；试验组的术中出血量低于对照组（P＜0.05）；试验组术中及术后并发症发生率为15.00%，低于对照组的30.00%（P＜0.05）；试验组术后胆漏、包虫复发、残腔感染发生率分别是5.00%、0.00%、0.00%，低于对照组的15.00%、10.00%、15.00%（P＜0.05）。结论 在肝包虫病的治疗中，经腹腔镜肝包虫囊外膜完整摘除术的优势显著，避免术中出血量多而引起风险，术中和术后出现并发症的概率较小，值得推广应用。

Abstract

Objective To compare the efficacy of laparoscopic complete removal of the outer membrane of hepatic hydatid cyst and laparoscopic removal of the inner capsule of hepatic hydatid cyst in the treatment of hepatic hydatid disease.
Methods Forty patients with confirmed diagnosis and surgical indications of hepatic hydatid cysts admitted to our hospital from January 2024 to October 2025 were selected as the research subjects. A prospective study was conducted, and they were randomly divided into a control group and an experimental group, with 20 cases in each group. The control group underwent laparoscopic removal of the hepatic hydatid cyst, while the experimental group underwent laparoscopic complete removal of the hepatic hydatid cyst outer membrane. The surgical time, intraoperative blood loss, and incidence of complications were compared between the two groups of patients.
Results There was no statistically significant difference in surgical time between the two groups (P>0.05); The intraoperative blood loss of the experimental group was lower than that of the control group (P<0.05); The incidence of intraoperative and postoperative complications in the experimental group was 15.00%, which was lower than the 30.00% in the control group (P<0.05); The incidence rates of postoperative bile leakage, hydatid cyst recurrence, and residual cavity infection in the experimental group were 5.00%, 0.00%, and 0.00%, respectively, which were lower than those in the control group of 15.00%, 10.00%, and 15.00% (P<0.05).
Conclusion   Laparoscopic complete removal of the outer membrane of hepatic hydatid cyst has significant advantages in the treatment of hepatic hydatid disease, avoiding risks caused by excessive intraoperative bleeding and reducing the probability of intraoperative and postoperative complications. It is worth promoting and applying.