Ann Surg Treat Res.  2014 May;86(5):232-236. 10.4174/astr.2014.86.5.232.

Laparoscopic treatment of hepatic cysts located in the posterosuperior segments of the liver

• Lee DH
• Cho JY
• Han HS
• Yoon YS
• Hwang DW
• Jung K
• Kim YK
• Shin HK
• Lee W

• KMID: 1889659
• DOI: http://doi.org/10.4174/astr.2014.86.5.232

Abstract

PURPOSE
Laparoscopy is considered the treatment of choice for hepatic cysts, especially those located in anterolateral segments (AL; segments II, III, IVb, V, and VI) because of the ease of laparoscopic access. Here, we evaluated the feasibility and safety of laparoscopic treatment of hepatic cysts in posterosuperior segments (PS; segments I, IVa, VII, and VIII).
METHODS
We retrospectively analyzed clinical data for 34 patients who underwent laparoscopic treatment of hepatic cysts between September 2004 and December 2012. Patients were divided into two groups depending on whether the main largest cyst was located in AL (n = 20) or PS (n = 14). Laparoscopic cyst unroofing was performed in 29 patients with symptomatic simple cysts. Laparoscopic resection was performed in 5 patients with suspected cystic neoplasms.
RESULTS
There were no deaths or major complications. The mean operation time was 110 minutes and the mean hospital stay was 4.4 days. The mean cyst size was not significantly different (P = 0.511) but the frequency of multiple cysts was significantly greater in group PS (P = 0.003). The predominant type of resection was unroofing in both groups (P = 0.251). The mean blood loss (P = 0.747), mean hospital stay (P = 0.812), mean operation time (P = 0.669), morbidity rate (P = 0.488), and relapse rate (P = 0.448) were not significantly different. Relapse occurred in one patient who underwent reunroofing 17 months later. The median follow-up is 62 months.
CONCLUSION
Laparoscopy is a safe procedure for hepatic cysts located in posterosuperior segments.

Keyword

Laparoscopy; Hepatic cyst; Posterosuperior

MeSH Terms

Follow-Up Studies
Humans
Laparoscopy
Length of Stay
Liver*
Recurrence
Retrospective Studies

Figure

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  Fig. 1 Aspiration of cystic fluid without spillage before laparoscopic unroofing.

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  Fig. 2 Resection of the cystic rim of the liver parenchyma using ultrasonic shears.

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