Role of fenestration and resection for symptomatic solitary liver cysts (original) (raw)
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ANZ Journal of Surgery, 2002
Background : The use of laparoscopic technique for management of symptomatic liver cysts is documented to be a feasible and safe procedure with good short-term symptomatic relief. However, it cannot be recommended as the standard of care as long-term results are scarce. The present study was initiated to review the long-term results of this approach in the management of symptomatic liver cysts. Methods : A retrospective review of all patients with symptomatic liver cysts that were treated by laparoscopic fenestration in our department over an 8-year period from 1993 to 2001. The clinical and radiographical data were analysed at follow-up to assess the outcome. Results : Eleven patients were treated using a laparoscopic approach; 10 patients with solitary cysts and one with adult polycystic liver disease. All patients achieved short-term alleviation of symptoms and an uneventful postoperative course. The mean hospital stay was 3 days. Long-term follow up was available for 9 patients with a mean of 44 months. Histologically, one of the patients was diagnosed with a biliary cystadenoma and she had a symptomatic recurrence and a liver resection at 20 months. In the other seven patients, there was no clinical recurrence but a radiographical recurrence of 28.5%. The patient with adult polycystic liver disease had two symptomatic recurrences: at 26 months where he underwent a repeat laparoscopic fenestration and at 43 months where he underwent an open fenestration. Conclusion : The present study confirms that with adequate patient selection, long-term alleviation of symptoms can be achieved with the laparoscopic approach for solitary simple liver cysts but not for polycystic liver disease or cystic tumours of the liver.
Laparoscopic Surgery
In the management of symptomatic nonparasitic simple liver cysts (SN-SLC), percutaneous sclerotherapy (PS) and laparoscopic fenestration (LF) represent the treatment options of choice. Recently, European guidelines on Interventional Ultrasound indicated PS as a good alternative to LF, with similar efficacy and lower complication rates. However, the choice of the best treatment options for SN-SLC remains a debated matter. Objective of this manuscript is to review the literature and to report on the short and long-term results of PS and LF for patients affected by SN-SLC. A Medline review of articles (July 1988-July 2019) concerning the over mentioned subject was performed. Papers considering pediatric patients, patients affected uniquely by polycystic liver disease, or less than five patients were excluded from the current analysis. Overall, 62 studies met inclusion criteria: one study comparing results of PS and LF, 40 and 21 studies reporting on results following LF and PS, respectively, accounting for an overall study population of 1,658 patients (1,037 and 621, respectively). Abdominal pain, eventually associated to fullness/ discomfort, was the main symptom at diagnosis. Overall morbidity rate was 8% (7.9% and 9.9% among the LF and PS groups, respectively). Mortality rate was nil among LF patients and 0.2% among PS patients. Following cyst treatment, rapid symptoms relief was observed in the majority of patients. Average follow-up duration was of 49 and 29 months among studies investigating LF and PS results, and symptoms recurrence necessitating for additional treatment was observed in 1.6% and 8.2% of patients treated with LF and PS, respectively. While PS, mainly performed using alcohol/minocycline, seems associated with a lower risk of perioperative complications and higher rate of symptoms recurrence, LF is indicated when differential diagnosis with other condition is necessary, in the presence of biliary communication, or after ineffective PS. However, a multidisciplinary decision is recommended for defining the most appropriate treatment.
Laparoscopic treatment of simple hepatic cysts and polycystic liver disease
Surgical Endoscopy And Other Interventional Techniques, 2003
Background: The authors present their experience in the laparoscopic management of hepatic cysts and polycystic liver disease (PLD). Methods: Between January 1996 and January 2002, 16 patients underwent laparoscopic liver surgery. Indications were solitary giant cysts (n = 10) and PLD (n = 6). Data were collected retrospectively. Results: Laparoscopic fenestration was completed in 15 patients. Median operative time was 80 min. There was no deaths. Complications occurred in four patients: one patient with a solitary liver cyst experienced diarrhea, while a pleural effusion, a bleeding from the trocar-insertion site, and ascites occurred in three patients with PLD. Median follow-up was 34 months. There was one asymptomatic recurrence (11%) in one patient with a solitary cyst. Two patients with PLD had a symptomatic recurrence of a liver cyst. Conclusion: Laparoscopic fenestration could be the preferred treatment of solitary liver cysts and PLD. Adequate selection of patients and type of cystic liver together with a meticulous surgical technique are recommended.
Pattern of liver cysts with their surgical management
International Journal of Research in Medical Sciences, 2022
Background: Liver cysts are seen in up to 5% of the population. 15-16% of such cysts are symptomatic. Symptomatic cysts are found more commonly in women who are over 50 years of age. Simple hepatic cysts are believed to be congenital in origin. Methods: The observational study was conducted in the department of hepatobiliary department of surgery of
Systematic review of laparoscopic versus open surgery in the treatment of non-parasitic liver cysts
Updates in Surgery, 2014
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Laparoscopic Management of Simple Liver Cysts
Laparoscopic management of simple liver cyst, 2019
This study was conducted in Tanta and Kafr-elsheikh university hospitals and included, twenty-two patients presented with simple liver cysts between April 2015 and Oct 2018. Our aim was to evaluate, feasibility and safety of the laparoscopic management of simple liver cysts. Laparoscopic unroofing of the cyst was the chosen technique. Results: The outcome of this technique was satisfactory with minimal morbidity and no mortality, only one patient suffered from postoperative collection treated by ultrasonic guided drainage also no recurrence was experienced during the follow up period.
Laparoscopic Management of Hepatic Cysts
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, 2006
The present study describes the technique and evaluation of postsurgical results, hospital stay, and follow-up of patients who underwent hepatic cyst surgical treatment by laparoscopic access. Twelve patients presenting liver cystic disease were included in this research. Clinical conditions, laboratorial and radiologic examinations, surgical technique, complications, and postoperative follow-up were discussed. In our series, the morbidity rate was 25%. No mortality was observed in the postoperative period. Conversion to open surgery was necessary in 1 case, owing to hemorrhage. No recurrence was found and patients remain asymptomatic in their current follow-up. Laparoscopic resection of hepatic cyst proved to be efficient in the regression of the cysts and resulted in disappearance of symptoms.
Minimally invasive management of hepatic cysts: indications and complications
European review for medical and pharmacological sciences, 2018
OBJECTIVE Liver cysts are divided into congenital and acquired. Congenital cystic lesions include polycystic liver disease, simple cysts, duct related and ciliated hepatic foregut cysts. Acquired cystic lesions are divided into infectious and non-infectious. The infectious cysts are the hydatid cyst, the amoebic abscess, and the pyogenic abscess, whereas the non-infectious cysts are neoplastic cysts and false cysts. While modern medicine provides a lot of minimally invasive therapeutic modalities, there has emerged a pressing need for understanding the various types of liver cysts, the possible minimal therapeutic options along with their indications and complications. We aim is to clarify the role of minimally invasive techniques in the management of hepatic cysts. MATERIALS AND METHODS A literature review was performed using the MEDLINE database. The search terms were: liver cyst, minimally invasive, laparoscopic, percutaneous, drainage and fenestration. We reviewed 82 English lan...
Laparoscopic treatment of nonparasitic hepatic cysts
Surgical Endoscopy, 2006
Background: We present our experience with laparoscopic deroofing of nonparasitic hepatic cysts. Methods: Laparoscopic deroofing was performed due to a solitary hepatic cyst in 21 patients and polycystic liver in four patients. Laparoscopy was indicated when a cyst was larger than 5 cm (the general size of cysts was 6.9 cm) and caused complaints and was in a superficial position. In eight patients in whom the cyst was larger than 10 cm, omentoplasty was performed. Results: Intraoperative complications were not detected. Two conversions were performed because of the deep position of the cyst. Postoperative bile leakage was detected in one case that was treated conservatively. The average hospital stay was 4.7 days. Relapse occurred in two patients (8%), but only one of them required a second operation. Conclusion: We recommend laparoscopic deroofing for treatment of nonparasitic liver cysts. This operation causes only slight discomfort for the patients, the intra-and postoperative morbidity is low, and relapses are rare.