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01-08-2004 | Original Article

Minimally invasive management of dysontogenetic hepatic cysts

Authors: Peter Kornprat, Herwig Cerwenka, Heinz Bacher, Azab El-Shabrawi, Manfred Tillich, Cord Langner, Hans Joerg Mischinger

Published in: Langenbeck's Archives of Surgery | Issue 4/2004

Abstract

Background

Liver cysts occur with a prevalence of 4%–7% in the general population. Laparoscopic surgery is effective for solitary cysts and in selected patients with polycystic liver disease (PLD). We present our experience in the laparoscopic management of dysontogenetic cysts.

Patients and methods

Between 1994 and 2002, 36 patients were referred to our centre for the management of dysontogenetic cystic liver disease. Management was laparoscopic in 16 cases. Indications were solitary giant cysts (n=9) and PLD (n=7).

Results

Laparoscopic procedures were completed in 15 patients. Mean operating time was 90 min. There were no deaths. In one case there was an intraoperative complication: bleeding from a superficial hepatic vein necessitated conversion to an open procedure. There were two postoperative complications: one patient with biliary leakage, which was managed conservatively, and one patient with a pneumothorax caused by the cava catheter installed for anaesthesia. Median follow-up was 36 months. There was no symptomatic recurrence.

Conclusion

Laparoscopy can be recommended as the procedure of choice for symptomatic solitary giant cysts and PLD Gigot type I.

Caremani M, Vincenti A, Benci A, Sassoli S, Tacconi D (1996) Echographic epidemiology of non-parasitic hepatic cysts. J Clin Ultrasound 21:115–118

Z’graggen K, Metzger A, Klaiber C (1991) Symptomatic simple cyst of the liver: treatment by laparoscopic surgery. Surg Endosc 5:224–225PubMed

Paterson-Brown S, Garden OJ (1991) Laser-assisted laparoscopic excision of liver cysts. Br J Surg 78:1047PubMed

Lange V, Meyer G, Rau H, Schildberg FW (1992) Minimal invasive Eingriffe bei solitären Lebercysten. Chirurg 63:349PubMed

Gigot JF, Legrand M, Hubens G, de Canniere L, Wibin E, Deweer F, Druart ML, Bertrand C, Devrieendt H, Droissart R, Tugilimana M, Hauters P, Vereecken L (1996) Laparoscopic treatment of nonparasitic liver cysts: adequate selection of patients and surgical technique. World J Surg 20:556–561CrossRefPubMed

Gigot JF, Jadoul P, Que F, Van Beers BE, Etienne J, Horsmanns Y, Collard A, Geubel A, Pringot J, Kestens PJ (1997) Is fenestration the most adequate operation for long-term management? Ann Surg 225:286–294CrossRefPubMed

Koperna T, Vogl S, Satzinger U, Schulz F (1997) Nonparasitic cysts of the liver: results and options of surgical treatment. World J Surg 21:850–855CrossRefPubMed

Fabiani P, Mazza D, Toouli J, Bartels M, Gugenheim J, Mouiel J (1997) Laparoscopic fenestration of symptomatic non-parasitic cysts of the liver. Br J Surg 84:321–322CrossRefPubMed

Martin IJ, McKinley AJ, Currie EJ, Holmes P, Garden J (1998) Tailoring the management of nonparasitic liver cysts. Ann Surg 228:167–172CrossRefPubMed

10.

Gigot JF, Metairie S, Etienne J, Horsmanns Y, van Beers BE, Sempoux C, Deprez P, Materne R, Geubel A, Glineur D, Gianello P (2001) The surgical management of congenital liver cysts. Surg Endosc 15:357–363CrossRefPubMed

11.

Berends FJ, Meijer S, Prevoo W, Bonjer HJ, Cuesta MA (2001) Technical considerations in laparoscopic liver surgery. Surg Endosc 15:794–798CrossRefPubMed

12.

Zacherl J, Scheuba C, Imhof M, Jakesz R, Függer R (2001) Long-term results after laparoscopic unroofing of solitary symptomatic congenital liver cysts. Surg Endosc 14:59–62CrossRef

13.

Ammori BJ, Jenkins BL, Lim PCM, Prasad KR, Pollard SG, Lodge PA (2002) Surgical strategy for cystic diseases of the liver in a Western hepatobiliary center. World J Surg 26:462–469CrossRefPubMed

14.

Tan YM, Ooi LL, Soo KC, Mack POP (2002) Does laparoscopic fenestration provide long-term alleviation for symptomatic cystic disease of the liver. ANZ J Surg 72:743–745CrossRefPubMed

15.

Duca S, Cazacu M, Vlad L, Paraion I, Iancu C, Toganel D, Rusu C (1993) Nonparasitic abdominal serous cysts. A multiple case report. Acta Chir Belg 93:18PubMed

16.

Sanfellipo PM, Beahrs OH, Weiland LH (1974) Cystic disease of the liver. Ann Surg 179:922–925PubMed

17.

Tahvanainen P, Tahvanainen E, Reijonen H, Halme L, Kaariainen H, Hockerstedt K (2003) Polycystic liver disease is genetically heterogeneous: clinical and linkage studies in eight Finnish families. J Hepatol 38:39–43CrossRefPubMed

18.

Li A, Davila S, Furu L, Quian Q, Tian X, Kamath PS, King BF, Torres VE, Somlo S (2003) Mutations in PRKCSH cause isolated autosomal dominant polycystic liver disease. Am J Hum Genet 72:691–703CrossRefPubMed

19.

Cowles RA, Mulholland MW (2000) Solitary hepatic cysts. J Am Coll Surg 191:311–321CrossRefPubMed

20.

Lin TY, Chen CC, Wang SM (1968) Treatment of non-parasitic cystic disease of the liver: a new approach to therapy with polycystic liver. Ann Surg 168:921PubMed

21.

Hansen P, Bhoyrul S, Legha P, Wetter A, Way LW(1997) Laparoscopic treatment of liver cysts. J Gastrointest Surg 1:53–47CrossRef

22.

Diez J, Decoud J, Gutierrez L, Suhl A, Merello J (1998) Laparoscopic treatment of symptomatic cysts of the liver. Br J Surg 85:25–27CrossRefPubMed

Title: Minimally invasive management of dysontogenetic hepatic cysts
Authors: Peter Kornprat
Herwig Cerwenka
Heinz Bacher
Azab El-Shabrawi
Manfred Tillich
Cord Langner
Hans Joerg Mischinger
Publication date: 01-08-2004
Publisher: Springer-Verlag
Published in: Langenbeck's Archives of Surgery / Issue 4/2004
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-004-0506-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Minimally invasive management of dysontogenetic hepatic cysts

Abstract

Background

Patients and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Patients and methods

Results

Conclusion

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