Symptomatic simple cysts of the liver: treatment by laparoscopic surgery

Z’graggen, Kaspar; Metzger, A.; Klaiber, C

doi:10.1007/bf02653270

Cited by 60 publications

(43 citation statements)

References 7 publications

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“…Laparoscopic treatment of non-parasitic, simple hepatic cysts was first described in 1991 in a 73-year-old patient who presented with symptomatic uncomplicated liver cysts [4]and in a 53-year-old woman suffering from breathlessness and a raised right hemidiaphragm due to a hemorrhage into a 16-cm diameter cyst [5]. Although randomized controlled trials with long-term outcomes are not available, laparoscopic treatment of uncomplicated parenchymal liver cysts is considered standard treatment.…”

Section: Role Of Laparoscopymentioning

confidence: 99%

“…While aspiration is accompanied by a high recurrence rate [3], surgical treatment may be associated with significant morbidity and mortality. Since laparoscopic deroofing for liver cysts was first described in 1991 [4, 5], there have been a number of reports of successful laparoscopic management of hepatic cysts, including laparoscopic management of ‘complex’ and parasitic cysts. The methods applied range from simple laparoscopic fenestration to laparoscopic pericystectomy and laparoscopic formal hepatic resection.…”

Section: Introductionmentioning

confidence: 99%

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Role of Laparoscopy in Hepatic Cyst Surgery

Gloor

Candinas³

2002

Dig Surg

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Background: Hepatic cysts are detected incidentally in 2.5–5% of the population. Only about 15% of such cysts are symptomatic. Since laparoscopic deroofing for liver cysts was first described in 1991 there have been a number of reports of successful laparoscopic management of hepatic cysts, including the laparoscopic management of complex and parasitic cysts. Methods: A systematic review of English-language articles on the subject appearing in journals through May 2002 was conducted using the Medline database. Results: Only a minority of cystic liver lesions need treatment, and the therapeutic approach is guided by the type of cyst. Laparoscopic deroofing (combined with omentoplasty and/or oversewing) of uncomplicated liver cysts is associated with a recurrence rate of 10–25%, with less morbidity and mortality as compared to open surgery. On the other hand, treatment of complex liver cysts and hydatid cysts by laparoscopy is not considered a standard approach. Conclusion: The laparoscopic approach in uncomplicated but symptomatic liver cysts is effective, with low morbidity and mortality. Additional omentoplasty or oversewing appears to reduce the recurrence rate.

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Section: Role Of Laparoscopymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Role of Laparoscopy in Hepatic Cyst Surgery

Gloor

Candinas³

2002

Dig Surg

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“…El tratamiento de estos pacientes es quirúrgico, siendo la mejor opción el acceso y tratamiento laparoscópico, cuyo primer reporte fue documentado en 1991 en Alemania (Z'graggen et al, 1991;Morino et al, 1994); a partir de cuándo la evidencia es hasta hoy suficientemente sólida para apoyar esta opción terapéutica.…”

Section: Discussionunclassified

Resultados de la Cirugía Laparoscópica en Quistes Hepáticos No Parasitarios

Manterola

2013

Int. J. Morphol.

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MANTEROLA, C. Resultados de la cirugía laparoscópica en quistes hepáticos no parasitarios. Int. J. Morphol., 31(3):1116-1119, 2013. RESUMEN:Los quistes hepáticos no hidatídicos (QHNH) se detectan de forma incidental, pueden ser únicos y múltiples. Desde que se describió el tratamiento laparoscópico de estos, se han reportado diversas series; existiendo por ende evidencia que avala la cirugía laparoscópica de estas lesiones. El objetivo de este estudio, es reportar los resultados del tratamiento laparoscópico de QHNH en términos de morbilidad postoperatoria (MPO). Serie de casos. Se incluyeron pacientes intervenidos quirúrgicamente vía laparoscópica por QHNH en el Hospital Clínico de la Universidad Mayor entre enero de 2008 y diciembre de 2012. El estudio preoperatorio consistió en exámenes generales, determinación de ELISA-IgE e IgG para hidatidosis, ecotomografía abdominal o tomografía computarizada. En el período estudiado, se intervinieron 17 pacientes con QHNH, resecándose en ellos, un total de 39 quistes. El 76,5% de los casos eran de sexo femenino; y la mediana de edad de la serie fue de 56 años. La mediana del diámetro ecográfico de las lesiones fue de 7,5 cm. Se realizó quistectomía subtotal en todos ellos, sin utilización de drenaje. Se realizó epiploplastia en 4 pacientes. En el 82,4% de los casos se ejecutó de forma simultánea una colecistectomía por colelitiasis. La mediana del tiempo quirúrgico fue de 51 minutos. No fue necesario convertir a ningún paciente. La serie no registra MPO ni mortalidad. La mediana de estancia hospitalaria fue de 1 día. El estudio histopatológico confirmó "quiste de tipo biliar" en la totalidad de los casos. Con un seguimiento mínimo de 6 meses, no se ha evidenciado MPO tardía ni reaparición de las lesiones resecadas. El tratamiento aplicado a esta serie de casos de QHNH, se asocia a escasa estancia hospitalaria y buena evolución a corto y mediano plazo.PALABRAS CLAVE: Enfermedades hepáticas; Quiste simple del hígado; Quiste seroso del hígado; Quiste no parasitario del hígado; Enfermedad poliquística del hígado. INTRODUCCIÓNLos quistes hepáticos no hidatídicos (QHNH); pueden ser quistes simples o biliares y la enfermedad poliquística hepática, que suele asociarse a quistes simples en ambos riñones. Constituyen formaciones quísticas intrahepáticas, recubiertas por un epitelio simple cuyo contenido es un líquido claro de características acuosas. No se comunican con la vía biliar; y se los ha denominado quistes hepáticos benignos, quistes uniloculares, quistes solitarios del hígado, quistes no parasitarios o quiste hepáticos congénitos. Son siempre benignos y no se malignizan.Si bien fueron considerados una entidad poco frecuente, se han reportado prevalencias en autopsias de adultos 1% al 5% (Amendolara et al., 2012); siendo más frecuente en mujeres, y aunque en su inmensa mayoría son asíntomáticos, pueden hacerse sintomáticos en sujetos de 40 a 50 años (Hansman et al., 2001). Con la aparición de la ultrasonografía y la tomografía su diagnóstico, a modo de hallazgo, se ha he...

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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%

“…Key words: Single-incision laparoscopic surgery -Liver cyst -Z-shaped umbilical incisionSaline-cooled radiofrequency device S ince the laparoscopic procedure was introduced for the fenestration of a simple liver cyst in 1991, 1 laparoscopic surgery for symptomatic nonparasitic liver cysts has been recognized as a widely acceptable procedure to relieve symptoms. [2][3][4][5] In contrast, there are still few reports on single-incision laparoscopic surgery (SILS) for liver cysts.…”

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confidence: 99%

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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Symptomatic simple cysts of the liver: treatment by laparoscopic surgery

Abstract: This report describes the case of a 73-year-old patient who presented with symptomatic uncomplicated liver cysts. Treatment of this case by laparoscopic surgery is described and a short review of the literature is presented.

Cited by 60 publications

References 7 publications

Role of Laparoscopy in Hepatic Cyst Surgery

Role of Laparoscopy in Hepatic Cyst Surgery

Resultados de la Cirugía Laparoscópica en Quistes Hepáticos No Parasitarios

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

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