Management of giant hepatic cysts in the laparoscopic era.
10.4174/jkss.2013.85.3.116
- Author:
Chan Joong CHOI
1
;
Young Hoon KIM
;
Young Hoon ROH
;
Ghap Joong JUNG
;
Jeong Wook SEO
;
Yang Hyun BAEK
;
Sung Wook LEE
;
Myung Hwan ROH
;
San Young HAN
;
Jin Sook JEONG
Author Information
1. Department of Surgery, Dong-A University College of Medicine, Busan, Korea. yhkim1@mail.donga.ac.kr
- Publication Type:Original Article
- Keywords:
Liver;
Hepatic cyst;
Laparoscopy
- MeSH:
Cystadenoma;
Hand;
Humans;
Laparoscopy;
Liver;
Multivariate Analysis;
Recurrence;
Reoperation;
Sclerotherapy
- From:Journal of the Korean Surgical Society
2013;85(3):116-122
- CountryRepublic of Korea
- Language:English
-
Abstract:
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.
