Abstract
This study presents the experience with laparoscopic deroofing of nonparasitic liver cysts at a single center over a 9-year period. A total of 25 patients, undergoing 32 operations, were identified. Median cyst diameter was 10 cm for de novo cysts and 9.5 cm for recurrent cysts. Six patients had multiple cysts consistent with polycystic liver disease. In total, there were 26 laparoscopic procedures and 2 open conversions. Four procedures were commenced as open, three of which were for recurrent cysts. Minor complications were bleeding from a port site (n=1), pneumothorax (n=2), and intra-abdominal collection (n=1). One major complication of bile leak and relaparotomy occurred following an open deroofing. No major complications were recorded for laparoscopic procedures. Symptomatic recurrence of cysts occurred in four patients with simple cysts (5%) and one patient with polycystic liver disease. We conclude that laparoscopic liver cyst deroofing is an effective method of dealing with symptomatic nonparasitic liver cysts.
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References
Caremani M, Vincentia A, Benci A, Sassoli S, Tacconi D (1996) Echographic epidemiology of non-parasitic liver cysts. J Clin Ultrasound 21:115–118
European PKD (1994) Consortium 77:881–894
Terada N, Shimizu T, Imai Y, et al. (1993) Benign, non-parasitic hepatic cyst causing obstructive jaundice. Intern Med 32:857–860
von Woellwarth J, Behrend M, Raab R (2000) Development of obstructive jaundice after haemorrhage into benign non-parasitic liver cyst. Chirugie 71:963–965
Torzilli G, Santambrogio R, Vellini S, Palmisano A, Donadon M, Montorsi M (2003) Inferior vena cava thrombosis: an unusual complication of a simple non-parasitic liver cyst requiring an integrated approach. Hepatogastroenterology 50:2188–2191
Lermitte E, Pessaux P, Jousset Y, et al. (2002) Compression of the inferior vena cava with thrombus: a rare complication of solitary liver cyst. Ann Chir 127:776–778
Le Treut YP, Toullec JL, Dor AM, Bartoli JM, Christophe M, Lafon M (1994) Haemobilia caused by a biliary cyst. Gastroenterol Clin Biol 18:285–288
Ibrarulah MD, Sreenivasa D, Sririam P, Padhy BP (1999) Giant non-parasitic hepatic cyst with biliary communication. Trop Gastroenterol 20:142–143
Gonzalez-Ojeda A, Medina-Franco H, Aldrete JS (1998) Spontaneous haemorrahge in liver neoplasms. experience at one institution. Rev Gastroenterol Mex 63:126–130
Buyse S, Asselah T, Vilgrain V, et al. (2004) Acute pulmonary embolism: a rare complication of a large non-parasitic liver cyst. Eur J Gastroenterol Hepatol 16:1241–1244
Weimann A, Klempnauer J, Gebel M, Maschek H, Bartels M, Ringe T (1996) Squamous cell carcinoma of the liver originating from a solitary non-parasitic liver cyst case report and review of literature. Hepatobil Surg 10:45–49
Pozniczek M, Wysocki A, Bobrzynski A, Krzywon J, Lptarczyk W, Budznski P (2005) Sclerosant therapy as first-line treatment for solitary liver cysts. Dig Surg 21:452–454
Sanchez H, Gagner M, Rossi RL, et al. (1991) Surgical management of nonparasitic cystic liver disease. Am J Surg 16:113–118
Martin I, McKinley A, Currie E, Holmes P, Garden J (1998) Tailoring the management of nonparasitic liver cysts. Ann Surg 228:167–172
Moorthy K, Mihissin N, Houghton PW (2001) The management of simple hepatic cysts: sclerotherapy or laparoscopic fenestration. Ann Roy Coll Surg 83:409–414
Guglieli A, Veraldi GF, Furlan F, Soardi GA, de Manzoni G (1991) The echo-guided percutaneous therapy of dysonotogenetic liver cysts. Ann Ital Chir 62:13–17
Koperna T, Vogl S, Satzinger U, Schulz F (1997) Nonparasitic cysts of the liver: results and options of surgical treatment. World J Surg 21:850–854
Saini S, Mueller PR, Ferrucci JT, Simeone JF, Wittenberg J, Butch RJ (1983) Percutaneous aspiration of hepatic cysts does not provide definitive therapy. Am J Roentgenol 141:559–560
Larssen TB, Rosendahl K, Horn A, Jenson DK, Rorvik J (2003) Single session alcohol sclerotherapy in symptomatic benign hepatic cysts performed with a time of exposure to alcohol of 10 min: initial results. Eur Radiol 13:2627–2632
Lopes HM, Portela FA, eSilva Pontes JM, Leitao MJ, Ribeiro JC, Franco DS (1998) Treatment of benign hepatic cysts by instillation of tetracycline hydrochloride. Hepatogastroenterology 45:496–499
Goldstein HM, Carlyle DR, Nelson RS (1976) Treatment of a symptomatic hepatic cyst by the instillation of pantopaque. Am J Roentgenol 127:850–853
Larssen TB, Rorvik J, Horn A, et al. (2004) Biochemical and cytologic analysis of cystic contents in benign non-parasitic symptomatic hepatic cysts before and after ethanol sclerotherapy. Acta Radiol 45:504–509
Cellier C, Cuenod CA, Deslandes P, Auroux J, Landi B, Siauve N (1998) Symptomatic hepatic cysts: treatment with single shot injection of minocycline hydrochloride. Radiology 206:205–209
Kakizaki K, Yamaguchi H, Teshima S (1998) Symptomatic liver cyst: special reference to surgical management. J Hepatobil Pancreat Surg 5:192–195
Tikkakosi T, Makela JT, Leinon S, et al. (1996) Treatment of symptomatic congenital liver cysts with single session percutaneous drainage and ethanol sclerosis: technique and outcome. J Vasc Intervent Radiol 7:235–239
Yamada N, Shinwaza H, Ukai K, Makino N, Matsuhashi T, Wakabayashi H (1994) Treatment of symptomatic liver cysts by percutaneous instillation of minocycline hydrochloride. Dig Dis Sci 39:2503–2509
Montorsi M, Torzilli G, Fumagalli U, et al. (1994) Percutaneous alcohol sclerotherapy of simple hepatic cysts. Results from a multicentre survey in Italy. Hepatobil Surg 8:89–94
Simonetti G, Plofili S, Sergiacoini GL, Meloni GB, Orlacchio A (1993) Percutaneous treatment of hepatic cysts by aspiration and sclerotherapy. Cardiovasc Intervent Radiol 16:81–84
Yoshida H, Onda M, Tajiri T, et al. (2003) Long-term results of multiple minocycline hydrochloride injections for the treatment of symptomatic solitary hepatic cysts. J Gastroenterol Hepatol 18:595–598
Yamamoto K, Sakaguchi H, Anai H, et al. (2005) Sclerotherapy for simple cysts with use of ethanolamine oleate: preliminary experience. Cardiovasc Intervent Radiol 28:751–755
Lange V, Meyer G, Rau H, Schildberg FW (1992) Minimal-invasive Eingriffe bei solitaren Lebercysten. Chirugie 63:349–352
Moritz E (1992) Laparoskopische Fenestrierung von solitaren Riesencysten der Leber. Chirurgie 63:379–380
Reck T, Kockerling F, Gastinger J, Schneider I, Bin Dayna K, Gall FP (1993) Laparoskopische Resektion nicht-parasitarer Leberzysten. Min Invasive Chir 2:14–19
Gigot JF, Legrand M, Hubens G, de Lanniere L, Wibin E, Deweer F (1996) Laparoscopic treatment of non parasitic liver cysts: adequate selection of patients and surgical technique. World J Surg 20:556–561
Giuliente F, D’Acapito F, Vellone M, Giovanni I, Nuzzo G (2003) Risk for laparoscopic fenestration of liver cysts. Surg Endosc 17:1735–1738
Tocchi A, Mazzoni G, Costa G, et al. (2002) Symptomatic nonparasitic liver cysts: options for and results of surgical treatment. Arch Surg 137:154–158
Zalaba Z, Tihanyi TF, Winternitz T, Nehez L, Flautner L (1999) The laparoscopic treatment of non-parasitic liver cysts. Five year experience. Acta Chir Hung 38:221–223
Roesch Dietlen F, Perez Morales A, Diaz Blanco F, Marnez Ferdinad D (1999) Laparoscopic treatment of non-parasitic liver cysts. Rev Gastroenterol Mex 64:56–60
Diez J, Decoud J, Gutierrez L, Suhl A, Merello J (1998) Laparoscopic treatment of symptomatic cysts of the liver. Br J Surg 85:25–27
Emmerman A, Zornig C, Lloyd DM, Peiper M, Bloeche C, Broelsch CE (1997) Laparoscopic treatment of non parasitic cysts of the liver with omental transposition flap. Surg Endosc 11:734–736
Fabiani P, Mazza D, Toouli J, Bartels AM, Gugenheim J, Mouiel J (1997) Laparoscopic fenestration of symptomatic non-parasitic liver cysts. Br J Surg 84:321–322
Morino M, Garone C, Festa V, Miglietta C (1996) Laparoscopic treatment of non parasitic liver cysts. Ann Chir 50:419–425
Zachler J, Imllof M, Fugger R, Fritsch A (1996) Laparoscopic deroofing of symptomatic congential liver cysts. Surg Endosc 10:813–815
Tan YM, Ooi LL, Soo KC, Mack P (2002) Does laparoscopic fenestration provide long-term alleviation for symptomatic cystic disease of the liver? Austral NZ J Surg 72:743–745
Fiamingo P, Tedeschi U, Veroux M, et al. (2003) Laparoscopic treatment of simple hepatic cysts and polycystic liver disease. Surg Endosc 17:623–626
Civello IM, Matera D, Maria G, Nigro C, Brandara F, Brisinda G (2005) Laparoscopic fenestration of symptomatic non-parasitic liver cysts. Hepatogastroenterology 52:849–851
Caetono-Junior EM, Linhares MM, Matos D, Scharibaman V, Matone J, Saad SS (2006) Laparoscopic management of hepatic cysts. Surg Laparosc Endosc Percutan Techn 16:68–72
Tan YM, Chung A, Mack P, Chow P, Khin LW, Ooi LL (2005) Role of fenestration and resection for symptomatic solitary liver cysts. Austral NZ J Surg 75:577–580
Que F, Nagorney DM, Gross JB, Torres VE (1995) Liver resection and cyst fenestration in the treatment of severe polycystic liver disease. Gastroenterology 108:487–494
Everson GT, Taylor MR, Doctor RB (2004) Polycystic liver disease. Hepatology 40:774–782
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Garcea, G., Pattenden, C.J., Stephenson, J. et al. Nine-Year Single-Center Experience with Nonparastic Liver Cysts: Diagnosis and Management. Dig Dis Sci 52, 185–191 (2007). https://doi.org/10.1007/s10620-006-9545-y
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DOI: https://doi.org/10.1007/s10620-006-9545-y