Laparoscopic Management of Benign Cystic Lesions of the Liver

Abstract

Background: Benign cystic lesions of the liver are rare conditions. Owing to the improvement in investigation modalities like ultrasound and CT scan these lesions are found frequently today. A safe and effective method of laparoscopic management for hepatic hydatid cysts, simple liver cysts and liver abscess is described along with a review of the relevant literature. Objectives: To report our experience in laparoscopic management of hepatic hydatid cysts, simple liver cysts and liver abscess with the outcome, feasibility and complications of the procedure. Methods: This was a prospective observational study held at BSMMU, BIRDEM, DMCH, ShMCH and some private hospital in Dhaka city from July 2014 to December 2014. Total sample size was thirty cases. All patients diagnosed on ultrasound and CT scan and who have ful-filed the inclusion and exclusions criteria were included in the study. Laparoscopic unroofing, evacuation inocleation and aspiration were done. Operative procedure, operation time, conversion to laparotomy, complications, and mortality and recurrence rates were analysed. Results: There were three groups of benign cystic lesions: hepatic hydatid cysts (n=18), simple liver cysts (n=8) and liver abscess (n=4). Mean age of the patients were 43.6 years with hydatid cysts, 46.7 years with simple liver cysts, and 59.6 years in patients with liver abscess. Minimum age was 17 years and maximum age was 69 years. Male patients were 10 in hydatid cysts group, 3 in simple liver cysts group and 3 in liver abscess group. Most of the patients presented with pain, 72.22% in hydatid cysts, 62.5% in simple liver cysts and 100% in liver abscess. Most of the lesions were single and they were located in the right lobe of the liver in majority of cases. Benign cystic lesions were successfully treated laparoscopcally in 29 cases. Open surgery conversion was needed in one case 3.33%, with hepatic hydatid cysts. Complications included port site infection in 2 (6.67%), one in .....