Analysis of unique liver volume restoration after laparoscopic fenestration of liver cysts

Summary Background Giant liver cysts causing compression symptoms require surgical therapy. Laparoscopy is nowadays considered the first-line approach and has been shown to be non-inferior to open surgery. Ancillary techniques and novel technologies may have the potential to reduce complications rates and improve long-term outcomes. Methods The management of a female patient with a giant and symptomatic liver cyst is reported, as is a literature search in PubMed and Scopus spanning the past two decades, with the aim of assessing current evidence regarding procedural details of laparoscopic deroofing. Results Wide laparoscopic deroofing of a 21-cm liver cyst arising from segment 6 was safely performed under indocyanine green fluorescence imaging using a combination of ultrasonic energy excision and stapling. A contemporary literature review showed that only 22 of the 35 publications included details of the surgical procedure. Ancillary techniques such as omentopexy, argon plasma coagulation, monopolar radiofrequency device ablation, and ethanol sclerotherapy were rarely used (10.8% of patients). Use of energy devices and/or linear staplers was reported in 22 (62.8%) studies. Indocyanine green fluorescence was reported in 4 (11.4%) studies. Conclusion The case report and the literature review show that wide laparoscopic deroofing of giant liver cysts is an effective and relatively simple procedure. Use of emerging technology such as indocyanine green fluorescence imaging can further enhance precision surgery and minimize complications and long-term recurrence rates.

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Laparoscopic deroofing of simple liver cysts: do ancillary techniques, surgical devices, and indocyanine green improve outcomes?

Kersik

Galassi

Colombo

et al. 2023

Eur Surg

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Laparoscopic Surgery in Nonparasitic Cysts of the Liver: Results Observed in a Series of Consecutive Cases

Manterola

Otzen²

2016

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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The purpose of this study was to report the results of laparoscopic treatment of nonparasitic cysts of the liver (NPCL) in terms of postoperative morbidity (POM) and recurrence. Prospective case series of patients operated on for NPCL at the Clínica Mayor in Temuco, Chile (2008 to 2015). The preoperative study consisted of general examinations, abdominal ultrasound or computed tomographic scan. The outcome variable was POM. Other variables of interest were surgical time, need for conversion, hospital stay, mortality, and recurrence. In the study period, 41 patients with NPCL underwent surgery. Median age of the series was 58 years, and 75.6% of the cases were female. The median ultrasound diameter of the lesions was 10 cm and surgical time was 50 minutes. All patients underwent a cystectomy. There was no conversion, no record of POM, mortality or recurrence. The treatment applied in this series of NPCL is associated with an adequate postoperative evolution.

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Analysis of unique liver volume restoration after laparoscopic fenestration of liver cysts

Abstract: Liver volume restoration after the fenestration of giant liver cysts non-uniformly occurs in the remnant liver. Improved portal vein circulation in the hepatic area adjacent to the excised giant liver cysts most likely regulates the greater regional volume restoration rate in the area.

Cited by 2 publications

References 20 publications

Laparoscopic deroofing of simple liver cysts: do ancillary techniques, surgical devices, and indocyanine green improve outcomes?

Laparoscopic deroofing of simple liver cysts: do ancillary techniques, surgical devices, and indocyanine green improve outcomes?

Laparoscopic Surgery in Nonparasitic Cysts of the Liver: Results Observed in a Series of Consecutive Cases

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