【摘要】 目的 分析左侧卧位腹腔镜肝右后叶肝脓肿切开引流临床疗效和安全性。方法 回顾分析我院2022年5月至2024年5月收治的32例采用左侧卧位腹腔镜肝右后叶肝脓肿切开引流术的患者资料，其中男性21例，女性11例。分别记录和分析围手术期指标、手术情况、术后住院天数、住院费用及随访情况等。结果 本研究纳入32例患者入院时均予以抗生素等基础治疗，脓肿直径(7.0±1.1)cm;期间均接受左侧卧位腹腔镜肝右后叶肝脓肿切开引流手术，无中转开腹。手术时间(89.5±23.7)min,术中出血量(20.6±7.3)ml,术后体温恢复时间(1.9±0.4)d,引流管留置时间(6.0±2.5)d,脓腔吸收消失时间(9.4±2.2)d,术后住院天数(10.1±2.5)d,住院总费用(1.8±0.6)万元。脓液标本送细菌培养10例(31.3%)阳性；术后7例(21.9%)患者出现少量胸腔积液；无术后出血、胆漏等严重并发症发生，无非计划性再次手术发生，所有患者均通过门诊或电话的方式随访6个月，所有病例近期无明显不适。结论 左侧卧位腹腔镜下切开引流肝右后叶肝脓肿操作简便，脓肿引流充分且疗效确切，尤其对于肝右后叶多房性的脓肿。更多还原

【Abstract】 Objective To analyze the clinical efficacy and safety of laparoscopic incision and drainage for liver abscess in the right posterior lobe via the left lateral decubitus position.Methods We retrospectively reviewed the data of 32 patients(21 males and 11 females) who underwent laparoscopic drainage of right posterior segment liver abscess in the left lateral decubitus position at our hospital from May 2022 to May 2024. Perioperative indicators, surgical outcomes, hospital stay duration, hospitalization costs, and follow-up data were recorded and analyzed.Results All 32 patients received preoperative antibiotic therapy, with an average abscess diameter of(7.0±1.1) cm. All procedures were successfully completed laparoscopically without conversion to open surgery. The operative time was(89.5±23.7) min, with an estimated blood loss of(20.6±7.3) mL. Postoperative recovery parameters included: time to normal body temperature(1.9±0.4) days, duration of drainage tube retention(6.0±2.5) days, time for complete abscess cavity resolution(9.4±2.2) days, postoperative hospital stay(10.1±2.5) days, and total hospitalization costs(18,000±6,000) CNY. Pus specimens were sent for bacterial culture, with 10 cases(31.3%) testing positive. Minor pleural effusion occurred in 7 cases(21.9%). No severe complications(e.g., postoperative hemorrhage or bile leakage) were observed, and no unplanned reoperations were required. All patients completed 6-month follow-up(via outpatient clinic or telephone interview) without reported recurrence or significant discomfort during the recent follow-up period.Conclusion Laparoscopic incision and drainage in the left lateral decubitus position is a feasible and effective approach for liver abscesses in the right posterior lobe, particularly multiloculated abscesses. It offers adequate drainage, favorable clinical outcomes, and a high safety profile.更多还原