Laparoscopic Deroofing of Giant Liver Cysts. Case Report and Technical Considerations.

VernacularTitle:巨大肝嚢胞に対する腹腔鏡下開窓術の経験
Author: Takashi KITA ; Kazuhiro KOTANI ; Kouji UNO ; Yuichi OHGOSHI ; Satoru KANETO ; Shinsuke MATSUNO
Publication Type:Journal Article
From:Journal of the Japanese Association of Rural Medicine 1997;45(5):696-701
CountryJapan
Language:Japanese
Abstract: Reports laparoscopic deroofing of liver cysts have drawn our attention recently. A laparoscopic approach has advantages as minimal access surgery, but has the possibility of causing complications by hemorrhage and bile leakage. In this paper, we described three surgical cases of symptomatic giant liver cysts. In case 1, hemorrhage occurred when we resected the cyst wall by electrocautery with the aid of a laparoscope. Therefore, in case 2, we resected the cyst wall with an endoscopic stapling device (ENDO GIA) for complete hemostasis and control of bile duct, because the peritoneal surface of the cyst was overlaid by thin parenchymal tissue. In case 3, we resected the cyst wall with laparoscopic coagulating shears (LCS), because the peritoneal surface of the cyst was mainly extrahepatic. This device reduces the risk of hemorrhage and damage to the liver. These patients were asymptomatic after operation and developed no signs of recurrence. We suggest that the laparoscopic deroofing of liver cysts with these devices, a simple, safe procedure, may become a primary method of treating symptomatic liver cysts.