PURPOSE: We sought to evaluate the feasibility and outcomes of laparoscopic resection of giant hepatic cysts and surgical success, focusing on cyst recurrence. METHODS: From February 2004 to August 2011, 37 consecutive patients with symptomatic hepatic cysts were evaluated and treated at Dong-A University Hospital. Indications were simple cysts (n = 20), multiple cysts (n = 6), polycystic disease (n = 2), and cystadenoma (n = 9). RESULTS: The median patient age was 64 years, with a mean lesion diameter of 11.4 cm. The coincidence between preoperative imaging and final pathologic diagnosis was 54% and half (n = 19) of the cysts were located in segments VII and VIII. Twenty-two patients had American Society of Anesthesiologists (ASA) classification I and II, and nine had ASA classification III. Surgical treatment of hepatic cysts were open liver resection (n = 3), laparoscopic deroofing (n = 24), laparoscopic cyst excision (n = 4), laparoscopic left lateral sectionectomy (n = 2), hand assisted laparoscopic procedure (n = 2), and single port laparoscopic deroofing (n = 2). The mean fellow-up was 21 months, and six patients (16%) experienced radiographic-apparent recurrence. Reoperation due to recurrence was performed in two patients. Among the factors predicting recurrence, multivariate analysis revealed that interventional radiological procedures and pathologic diagnosis were statistically significant. CONCLUSION: Laparoscopic resection of giant hepatic cysts is a simple and effective method to relieve symptoms with minimal surgical trauma. Moreover, the recurrence is dependent on the type of pathology involved, and the sclerotherapy undertaken.
Cystadenoma ; Hand ; Humans ; Laparoscopy ; Liver ; Multivariate Analysis ; Recurrence ; Reoperation ; Sclerotherapy

BACKGROUND: To evaluate the cellular immune response to interferon(IFN)-alpha and ribavirin combination therapy in patients with chronic hepatitis C, we monitored serum levels of soluble IL-2 receptor(sIL2R) before and after the therapy. METHODS: Serum sIL2R levels before and after the combination therapy were measured in 19 patients with chronic hepatitis C. IFN(3 MU/day, 3 times/week) and ribavirin 1000 mg/day were administered for 24 weeks to all patients. RESULTS: After the therapy, sIL2R levels were increased (before, 3.13 0.67 ng/m L, and after 4.08 2.13 ng/mL, p=0.059) but statistically insignificant(p>0.05). The patients were divided into two groups : the responder group who were negative for serum hepatitis C virus(HCV)-RNA after the therapy, and the non-responder group who were still positive for HCV-RNA after the therapy. Between these two groups, sIL2R levels before and after the therapy were not significantly different. The ratio of sIL2R levels before and after the therapy was calculated, although the ratio was higher in responder group, but there was no significant difference between the two groups(sIL2R after the therapy)/(sIL2R before the therapy) : 1.43 0.70 in the responder group and 1.04 0.28 in the nonresponder group, p=0.096). CONCLUSION: Although these results failed to demonstrate that sIL2R level was increased during the combination therapy in patients with hepatitis C, this study suggested that cytokines which mediate immune response may be involved in the pathogenesis of chronic heaptitis C virus infection.
Cytokines ; Hepacivirus ; Hepatitis C ; Hepatitis C, Chronic* ; Hepatitis, Chronic* ; Humans ; Immunity, Cellular ; Interferon-alpha ; Interferons* ; Interleukin-2* ; Receptors, Interleukin-2* ; Ribavirin*