Laparoscopic Treatment of Nonparasitic Cysts of Spleen and Liver

Abstract

Laparoscopic treatments of nonparasitic splenic and liver cysts in the period between March 1993 and April 1995 have been reported: partial decapsulation-fenestration and evacuation of a splenic pseudocyst in one patient, fenestration of large congenital liver cysts with total excision of a few smaller liver cysts in two patients and two unsuccessful treatments of splenic cysts. After successful laparoscopic procedures the patients experienced immediate and complete relief of the symptoms. Two years after the splenic cyst procedure and 6 months after the liver cyst operation, the patients remained free of the symptoms, and complete absence of the cysts was confirmed by computerized tomography scans. Laparoscopic fenestration of nonparasitic splenic and liver cysts with total excision of smaller liver cysts is a simple and safe surgical method with lower morbidity and a quick return to normal activity.

Open and Laparoscopic Treatment of Nonparasitic Splenic Cysts

“…Since then, including our 4 cases, 32 case reports have demonstrated the feasibility of laparoscopic cyst wall unroofing (table 1). Of 3 cases reported by Cala et al [16], 2 cases were converted to open resection because of adhesions surrounding the spleen in 1 case and the intrasplenical location of the cyst in the other case [16]. No conversions due to bleeding complications are reported.…”

“…Cysts in the posterior surface of the spleen are found to be more difficult for a laparoscopic treatment since the spleen has to be widely mobilized. In the case of a centrally located splenic cyst, a laparoscopic procedure should not be attempted [16]. These difficult cases are probably best treated by open partial splenic resection.…”

Laparoscopic splenectomy: the clinical practice guidelines of the European Association for Endoscopic Surgery (EAES)

“…Depending on whether the cyst wall has an epithelial lining, they can be subdivided into primary (i.e., true) or secondary splenic cyst (i.e., pseudocyst). Nonparasitic splenic cysts account for about 75% (range, 50-80%) of cystic spleen lesions and are mostly pseudocysts because of prior trauma to the abdomen [53][54][55]. Primary nonparasitic cysts are regarded as congenital [56].…”

Partial laparoscopic decapsulation of congenital splenic cysts: a medium-term evaluation proves the efficiency in children

“…Kaiwa et al [6] performed a partial laparoscopic splenectomy for true splenic cysts in two patients and achieved definite treatment. Cala et al [2] described a simplified procedure for partial laparoscopic decapsulation and reported its efficiency. However, in children, only a few case reports are available to testify to the feasibility of a minimally invasive approach; substantial series focusing on the long-term success are still missing.…”