Abstract：
BACKGROUND: Symptomatic non-parasitic hepatic cysts with biliary communication are rare and no standard treatment has been established yet. Careful attention should be paid to avoidance of postoperative bile leakage during surgical treatment.
METHODS: We report the case of a 74-year-old man who visited our department complaining of right upper abdominal pain and elevated serum levels of the liver enzymes. Computed tomography revealed hepatic cysts including a large one measuring 16cm in diameter in Segments IV and VIII. Percutaneous drainage of the cyst revealed bile-staining of the cyst fluid. Endoscopic retrograde cholangiography demonstrated the presence of a cyst-biliary communication. We performed open deroofing of the cyst. During the operation, the biliary fistula was invisible, however, air injection into the bile duct through the stump of the cystic duct caused release of air bubbles from the cyst cavity, which allowed us to detect the small biliary orifice and repair it successfully by suture.
CONCLUSIONS: We utilized the intraoperative air leak test, which has previously been reported to be effective for preventing postoperative bile leakage in patients undergoing hepatectomy to detect of a small cyst-biliary communication in a case undergoing non-parasitic hepatic cyst surgery.
CONCLUSIONS: An intraoperative air leak test may be a useful test during surgical treatment of non-parasitic hepatic cysts with biliary communication.
METHODS: We report the case of a 74-year-old man who visited our department complaining of right upper abdominal pain and elevated serum levels of the liver enzymes. Computed tomography revealed hepatic cysts including a large one measuring 16cm in diameter in Segments IV and VIII. Percutaneous drainage of the cyst revealed bile-staining of the cyst fluid. Endoscopic retrograde cholangiography demonstrated the presence of a cyst-biliary communication. We performed open deroofing of the cyst. During the operation, the biliary fistula was invisible, however, air injection into the bile duct through the stump of the cystic duct caused release of air bubbles from the cyst cavity, which allowed us to detect the small biliary orifice and repair it successfully by suture.
CONCLUSIONS: We utilized the intraoperative air leak test, which has previously been reported to be effective for preventing postoperative bile leakage in patients undergoing hepatectomy to detect of a small cyst-biliary communication in a case undergoing non-parasitic hepatic cyst surgery.
CONCLUSIONS: An intraoperative air leak test may be a useful test during surgical treatment of non-parasitic hepatic cysts with biliary communication.
摘要：
背景：有症状的非寄生虫性肝囊肿伴胆道流通是罕见的，目前还没有建立标准的治疗方法。手术治疗时应注意避免术后胆漏。
方法：我们报告了一例74岁的男性，他到我们科室就诊，抱怨右上腹痛和血清肝酶水平升高。计算机断层扫描显示肝囊肿，包括IV和VIII段直径为16cm的大囊肿。囊肿的经皮引流显示囊肿液的胆汁染色。内镜逆行胆管造影显示存在囊肿-胆道通讯。我们对囊肿进行了开放性脱毛。在操作过程中,胆瘘是看不见的,然而,通过胆囊管的残端将空气注射到胆管中，导致气泡从囊肿腔中释放，这使我们能够检测到小的胆道口并通过缝合成功修复它。
结论：我们利用术中漏气测试，先前已报道，该方法可有效预防接受肝切除术的患者术后胆漏，以在接受非寄生虫性肝囊肿手术的病例中检测到小的囊肿-胆道连通。
结论：术中漏气试验可能是手术治疗非寄生虫性肝囊肿合并胆道连通的有用试验。
方法：我们报告了一例74岁的男性，他到我们科室就诊，抱怨右上腹痛和血清肝酶水平升高。计算机断层扫描显示肝囊肿，包括IV和VIII段直径为16cm的大囊肿。囊肿的经皮引流显示囊肿液的胆汁染色。内镜逆行胆管造影显示存在囊肿-胆道通讯。我们对囊肿进行了开放性脱毛。在操作过程中,胆瘘是看不见的,然而,通过胆囊管的残端将空气注射到胆管中，导致气泡从囊肿腔中释放，这使我们能够检测到小的胆道口并通过缝合成功修复它。
结论：我们利用术中漏气测试，先前已报道，该方法可有效预防接受肝切除术的患者术后胆漏，以在接受非寄生虫性肝囊肿手术的病例中检测到小的囊肿-胆道连通。
结论：术中漏气试验可能是手术治疗非寄生虫性肝囊肿合并胆道连通的有用试验。
