Single-incision laparoscopic management of a giant hepatic cyst

Willems, Kaitlin; Monsivais, Sharon; Vassaur, Hannah; Buckley, F. Paul

doi:10.1093/jscr/rjv073

Cited by 3 publications

(4 citation statements)

References 9 publications

(15 reference statements)

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“…Simple hepatic cysts are most frequent asymptomatic and often the diagnosis is made by incidental finding of abdominal imaging for another cause. [ 3 4 ] Symptoms when present are usually due to mass effect[ 2 ] or secondary infection from mild symptoms to acute peritonitis by the rupture of pyogenic liver abscess into the abdominal cavity. [ 7 ]…”

Section: Discussionmentioning

confidence: 99%

“…Simple hepatic cysts are most frequent asymptomatic and often the diagnosis is made by incidental finding of abdominal imaging for another cause. [3,4] Symptoms when present are usually due to mass effect [2] or secondary infection from mild symptoms to acute peritonitis by the rupture of pyogenic liver abscess into the abdominal cavity. [7] Despite the high mortality rate associated with hepatic pyogenic abscess, the development of minimally invasive techniques together with the improvement of intensive care reduced the mortality associated with this pathology.…”

Section: Discussionmentioning

confidence: 99%

“…Simple hepatic cysts are common in the population, with incidence ranging from 3% to 10%. [ 1 2 ] The cysts can be divided into congenital, neoplastic, inflammatory, and traumatic. [ 3 ] The most frequent are congenital and include simple cysts and polycystic liver disease.…”

Section: Introductionmentioning

confidence: 99%

“…[3] Small simple cysts are generally asymptomatic and do not require specific treatment. However, giant cysts may present with compressive symptoms, bleeding, and infection, [1,2] and the treatment is recommended in symptomatic patients. Among the possible complications, infection is one of the most feared one and has a mortality up to 19%.…”

Section: Introductionmentioning

confidence: 99%

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Giant simple biliary cyst infection treated with minimally invasive percutaneous drainage

et al. 2018

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We describe a minimally invasive alternative approach in a patient with infected hepatic cyst to stabilize the patient before definitive surgery. A 58-year-old man presented with fever and hypotension after 2 weeks of asthenia, chills, weight loss, slight abdominal pain, and a previous asymptomatic simple hepatic cyst. On ultrasound, a giant heterogeneous hepatic cyst with thick wall was noted. A positron emission tomography-computed tomography scan was indicated and demonstrated high uptake (standardized uptake value = 7.6) in the wall of the cyst, suggestive of infection. He underwent percutaneous drainage guided by the tomography. A 12 Fr drain was positioned inside the collection and 5 L of purulent material was aspirated from the cyst, and at day 12th, surgical resection was performed. Histopatological analysis confirmed a simple biliary cyst. The patient remains asymptomatic on 1-year follow-up. Percutaneous drainage before surgical treatment allowed the definitive approach to be performed with the patient in better clinical conditions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Giant simple biliary cyst infection treated with minimally invasive percutaneous drainage

et al. 2018

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

et al. 2023

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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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Application of stapling devices in liver surgery: Current status and future prospects

Yao¹,

Wu²

2016

WJG

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The liver is a vascular-rich solid organ. Safe and effective dissection of the vessels and liver parenchyma, and control of intraoperative bleeding are the main concerns when performing liver resection. Several studies have confirmed that intraoperative blood loss and postoperative transfusion are predictors of postoperative morbidity and mortality in liver surgery. Various methods and instruments have been developed during hepatectomy. Stapling devices are crucial for safe and rapid anastomosis. They are used to divide hepatic veins and portal branches, and to transect liver parenchyma in open liver resection. In recent years, laparoscopic liver surgery has developed rapidly, and is now preferred by many surgeons. Stapling devices have also been gradually introduced in laparoscopic liver surgery, from dividing vascular and biliary structures to parenchymal transection. This may be because staplers make manipulation more simple, rapid and safe. Even in single incision laparoscopic surgery, which is recognized as a new minimally invasive technique, staplers are also utilized, especially in left lateral hepatectomy. For safe application of stapling devices in liver surgery, more related designs and modifications, such as application of a suitable laparoscopic articulating liver tissue crushing device, a staple line reinforcement technique with the absorbable polymer membrane or radiofrequency ablation assistance, are still needed. More randomized studies are needed to demonstrate the benefits and find broader indications for the use of stapling devices, to help expand their application in liver surgery.

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Single-incision laparoscopic management of a giant hepatic cyst

Cited by 3 publications

References 9 publications

Giant simple biliary cyst infection treated with minimally invasive percutaneous drainage

Giant simple biliary cyst infection treated with minimally invasive percutaneous drainage

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

Application of stapling devices in liver surgery: Current status and future prospects

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