Laparoscopic treatment of simple hepatic cysts and polycystic liver disease

Fiamingo, Pietro; Tedeschi, Umberto; Veroux, Massimiliano; Cillo, Umberto; Brolese, Alberto; Rold, A. Da; Madia, Carol; Zanus, Giacomo; D’Amico, Davide

doi:10.1007/s00464-002-9088-z

Cited by 75 publications

(76 citation statements)

References 19 publications

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“…Drenth et al [4] reported a recurrence rate of 24%, complication rate of 22%, and mortality rate of 2% in 311 patients. Recently, laparoscopic fenestration has been increasingly reported, but the complication and recurrence rates are similar to those caused by open fenestration [4,5], and sufficient evaluation is necessary for its application.…”

Section: Discussionmentioning

confidence: 99%

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Monoethanolamine Oleate Sclerotherapy for Polycystic Liver Disease

Takita¹,

Iwanishi²,

Minami³

et al. 2016

Dig Dis

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Objective: The objective of treatment for polycystic liver disease is to reduce the liver volume and reduce or resolve compression symptoms such as abdominal fullness and abdominal pain due to hepatomegaly. Liver cysts are treated internally by puncture and aspiration of the cyst contents or hepatic artery embolization and surgically by cyst fenestration or hepatectomy, but no clear consensus has been reached concerning their selection. We introduced monoethanolamine oleate (EO) sclerotherapy therapy for liver cysts in 1999 and reported its effectiveness. In this study, cases were added, and the results including those of long-term follow-up were evaluated. Subjects: Twenty-two patients (5 males and 17 females, mean age 65.2) who underwent EO infusion therapy for liver cysts between January 1999 and June 2011 were evaluated. Methods: Liver cysts were punctured under ultrasound guidance, and a 7Fr pigtail catheter was inserted. After aspirating the cyst contents, EO was infused, and a clamp was applied for 24 h. Then, the catheter was declamped, cyst contents were aspirated again, and the catheter was removed. After the treatment, the cyst size was measured, and the patients were followed up. Results: Eight simple cysts in 8 patients (simple cyst group) and 21 cysts in 14 patients with multiple cysts (polycystic liver disease group) were treated and followed up over a median of 78 months (0-203 months). The mean volume reduction rate was 99% in the simple cyst group and 91% in the polycystic liver disease group (p = 0.04). One procedural accident resulting in liver abscess formation was observed in 1 patient 1 week after discharge, and it required drain placement and antibiotic administration. While mild abdominal pain was observed in a few patients, it was resolved spontaneously under observation. Conclusion: EO infusion therapy achieves fairly high treatment response in the volume reduction (99%) and sustained shrinkage over long-term follow-up. Therefore, this is a breakthrough technique in the treatment of polycystic liver disease as well as simple cyst and should be a standard of care in the treatment of this disease.

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Section: Discussionmentioning

confidence: 99%

“…Fenestration is less invasive than hepatectomy, and, recently, it has been found that the procedure may be performed laparoscopically. The most frequent perioperative complication is ascites, the incidence of which is 24%, and the recurrence rate has been reported to be 20% [4,5]. …”

Section: Introductionmentioning

confidence: 99%

Monoethanolamine Oleate Sclerotherapy for Polycystic Liver Disease

Takita¹,

Iwanishi²,

Minami³

et al. 2016

Dig Dis

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“…A cystadenocarcinoma is a malignant neoplasm and therefore resection is the definitive management. Due to their potential for malignant transformation, formal resection is also advised for cystadenomas [1,4,21,22]. Four of our patients were asymptomatic leading up to surgery.…”

Section: Discussionmentioning

confidence: 99%

Surgical Management of Simple Liver Cysts: A 10-Year Single-Center Experience

et al. 2015

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“…Mit zunehmender Größe der Zyste steigen jedoch die Rezidivquote, die Anzahl der nötigen Injektionen und damit die Komplikationsrate [2]. Die chirurgische Behandlung (laparoskopisches "unroofing") zeigt eine Rezidivrate von 0-15% [3] sowie eine Morbidität von bis zu 25% [4,5]. Komplikationen sind u.a.…”

Section: Fallbeschreibungunclassified