Long-term results after surgical treatment of nonparasitic hepatic cysts

Loehe, Florian; Globke, Brigitta; Marnoto, R.; Bruns, C.; Graeb, Christian; Winter, Hauke; Jauch, K.-W.; Angele, Martin K.

doi:10.1016/j.amjsurg.2009.06.031

Cited by 37 publications

(40 citation statements)

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“…Hemorrhage and biliary injury are, although rare, possible complications [16] . There is no associated mortality and morbidity ranges from 0%-15%, with reoperation rates at 9% [17] . There is no randomized prospective study to date comparing fenestration and sclerotherapy.…”

Section: Simple Cystmentioning

confidence: 99%

Current management of noninfectious hepatic cystic lesions: A review of the literature

Macedo¹

2013

WJH

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Nonparasitic hepatic cysts consist of a heterogeneous group of disorders, which differ in etiology, prevalence, and manifestations. With improving diagnostic techniques, hepatic cysts are becoming more common. Recent advancements in minimally invasive technology created a new Era in the management of hepatic cystic disease. Herein, the most current recommendations for management of noninfectious hepatic cysts are described, thereby discussing differential diagnosis, new therapeutic modalities and outcomes. Key words: simple hepatic cyst; Noninfectious; Polycystic liver disease; Cystadenoma; Cystadenocarcinoma; Caroli's disease; sclerotherapy; Fenestration Core tip: Nonparasitic hepatic cysts consist of a broad spectrum of entities ranging from benign developmental cysts to malignant neoplasms. With recent advancements in diagnostic studies, hepatic cysts are becoming more frequent and better understanding of risk factors, management and long-term outcomes, and further development of current therapeutic modalities are needed.

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Section: Simple Cystmentioning

confidence: 99%

Current management of noninfectious hepatic cystic lesions: A review of the literature

Macedo¹

2013

WJH

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“…Although laparoscopic fenestration has become a standard approach for the treatment of liver cysts, [1][2][3][4][5] there are still few reports regarding SILS for liver cysts, 6-10 when compared with other diseases, i.e., cholecystectomy, 13 appendectomy, 14 splenectomy, 15 and pancreatic resection. 16 To avoid the recurrence of a liver cyst after surgery, wide fenestration and ablation of the remnant membrane of the cystic wall are recognized as essential and important techniques.…”

Section: Discussionmentioning

confidence: 99%

“…16 To avoid the recurrence of a liver cyst after surgery, wide fenestration and ablation of the remnant membrane of the cystic wall are recognized as essential and important techniques. [2][3][4][5] To perform wide fenestration, dis-section of the thick part of the cystic wall is required but includes the potential risk of bile leakage after surgery. As a countermeasure against this complication, the application of a laparoscopic running suture of the thick margin of the cystic wall is widely accepted 2 ; however, this suturing procedure is technically demanding in SILS.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4][5] In contrast, there are still few reports on single-incision laparoscopic surgery (SILS) for liver cysts. [6][7][8][9][10] Ablation of the remnant membrane of the cystic wall is recognized as an important procedure for the prevention of recurrence.…”

mentioning

confidence: 99%

“…[6][7][8][9][10] Ablation of the remnant membrane of the cystic wall is recognized as an important procedure for the prevention of recurrence. [2][3][4][5] In general, an argon beam coagulator is useful for such ablation, however, in laparoscopic surgery, intraoperative pulmonary embolism due to argon gas has been reported. 11,12 We herein describe our experience with SILS for a huge liver cyst with the application of an umbilical Z-shaped incision using a gel port and a highdensity monopolar saline-cooled radiofrequency device with a successful outcome.…”

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confidence: 99%

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Application of a Z-Shaped Umbilical Incision and a Saline-Cooled Radiofrequency Device to Single-Incision Laparoscopic Surgery for a Huge Liver Cyst: Report of a Case

Igami

Tsuchiya

Yokoyama

et al. 2015

International Surgery

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When compared with other diseases, few authors have reported on single-incision laparoscopic surgery (SILS) for liver cysts. We herein describe our experience with SILS for a huge liver cyst with the application of an umbilical Z-shaped incision using a gel port and a high-density monopolar saline-cooled radiofrequency device with a successful outcome. An 80-old-year woman was diagnosed with a huge liver cyst with abdominal pain. She underwent percutaneous drainage of the liver cyst and injection of both absolute ethanol and an antimicrobial agent into the liver cyst at the previous hospital. Because of re-expansion of the liver cyst and symptom recurrence, we performed SILS for the liver cyst. An umbilical Z-shaped incision was made for gel port placement. After aspiration of the cystic fluid and dissection of the thin cystic wall by laparoscopic coagulating shears, the thick cystic wall was divided using an endoscopic linear stapler to avoid bleeding and bile leakage. After wide fenestration, a high-density monopolar saline-cooled radiofrequency device was applied for the ablation of the remnant membrane of the cystic wall. All maneuvers could be performed only through the gel port. The patient was discharged 4 days after surgery and was satisfied with the cosmetic results. This case shows that the application of an umbilical Zshaped incision using a gel port and a high-density monopolar saline-cooled radiofrequency device is useful for the accomplishment of SILS for a huge liver cyst.

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