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腹腔鏡下肝切除術は保険適応となり普及してきている．腹腔鏡下肝切除における重篤な合併症の報告は少ない．今回，腹腔鏡下肝右葉切除術20ヶ月後に発生した横隔膜ヘルニア嵌頓に対して，腹腔鏡下に嵌頓を解除し横隔膜縫縮術を施行した症例を経験したので報告する．
Incarcerated diaphragmatic hernia after laparoscopic right hepatectomy is ver...y rare. An 81-year-old man underwent laparoscopic right hepatectomy for giant hepatic hemangioma. Twenty months after the surgery, he began to complain of nausea and abdominal pain and was brought to our hospital. Chest X-ray showed an abdominal gas shadow above the right diaphragm and computed tomography showed herniation of the colon into the right thoracic cavity. We diagnosed ileus due to incarcerated diaphragmatic hernia and performed emergency operation under laparoscopic surgery. After successfully reducing the prolapsed colon back to the abdominal cavity, the diaphragmatic hernia orifice was repaired. Incarcerated diaphragmatic hernia sometimes causes the fatal state. Clinicians must therefore consider such findings a late complication of laparoscopic hepatectomy.続きを見る
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