Laparoscopic approach for the treatment of symptomatic non-parasitic liver cysts is effective and minimally invasive

Abstract

Background Non-parasitic liver cysts are frequently observed, but only those that are symptomatic or complicated need to be treated. Laparoscopic deroofing can be performed with minor parenchymal trauma, avoiding complications of the large surgical wound of laparotomy. Some authors recommend an open surgical approach for those cysts located in the posterior segments of the liver. The aim of this study was to evaluate the results of laparoscopic deroofing of non-parasitic liver cysts. Methods A survey was carried out among several members of the Argentine Chapter of the IHPBA. The survey included details of surgical technique, peroperative complications, hospital stay, mortality and persistence or relief of symptom. Results Seventeen symptomatic patients were included. Twenty-four cysts were treated with wide deroofing. Two huge cysts located in the posterior segment of the right liver required a lateral approach. There were no conversions to open operation and no deaths. A low rate of mild complications was found (shoulder-tip pain in 2 patients). The mean hospital stay was 2 days (1–5 days). During a mean follow-up of 23 months (3–48 months), I patient developed recurrence (6%) and has been successfully re-operated by laparoscopy, while another still had a residual cyst cavity. Both patients are asymptomatic at 2 years. Discussion Laparoscopic approach for wide deroofing of symptomatic non-parasitic liver disease has demonstrated good results, even for large cysts in the right lobe, for which a lateral approach is advised. Omentoplasty is recommended in cases of large cavities. Re-operations may be feasible, since this procedure produces fewer adhesions than open operation.