Conservative Techniques Research Articles

Minimal intervention dentistry for treating primary teeth: a survey study among members of the Israeli Society of Paediatric Dentistry.

To assess the attitudes of dentists in Israel to minimal intervention on primary teeth. For this cross-sectional study, data were accessed from questionnaires that were completed anonymously by members of the Israeli Society of Paediatric Dentistry. For four clinical scenarios, the respondents were asked to describe the stage at which they would intervene, the type of preparation they would utilize, and the restorative materials they would use. The scenarios included proximal and occlusal caries in the primary molar and buccal and proximal caries in the primary maxillary incisor. Forty-six dentists completed the questionnaire. Forty-one (89%) cited that they would intervene in stages 3 and 4 (of 6) of proximal caries in the primary molar; 34 of these stated that the cavity preparation would be of the proximal box type. For occlusal caries, 37 (80%) stated they would intervene in stages 2 and 3 (of 5); 31 of these would only remove the carious lesion. Thirty-three (72%) of the respondents stated they would intervene in stage 3 (of 4) of buccal caries; 31 (67%) stated they would intervene in stage 2 (of 4) of proximal caries in the primary maxillary incisor. The study reveals that specialists and non-specialists dentists in Israel use minimally invasive dentistry to treat children, either by intervening at a later stage of tooth decay or by employing conservative techniques to restore teeth. This aligns with the philosophy of minimal intervention.

Exploring the Impact of Access Cavity Designs on Canal Orifice Localization and Debris Presence: A Scoping Review.

One of the primary objectives in endodontics is to achieve thorough cleaning and disinfection of the root canal system during an endodontic procedure. This aims to reduce microbial contamination and prevent the development of endodontic lesions. To attain this goal, it is imperative to establish access to the endodontic space that allows for the complete removal of pulp tissue and the accurate identification of canal orifices while preserving the anatomical integrity of the root floor and pulp chamber as much as possible. In this scoping review, we aim to explore aspects related to the identification of canal orifices and the presence of pulp debris and residues during endodontic treatment. Specifically, we aim to assess whether and to what extent the design of the access cavity impacts these factors. The scoping review was conducted and prepared following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PRISMA Extension for Scoping Reviews [PRISMA-ScR]). The search yielded a total of 3697 bibliographic sources. After eliminating duplicates and applying eligibility criteria, only 10 studies were included. In conclusion, our review, conducted following PRISMA guidelines, includes 10 studies and suggests a potential trend: conservative techniques may generate more debris, whereas guided techniques exhibit superior precision in locating canal openings.

TRAUMATISMOS DENTAIS NA INFÂNCIA E SUAS IMPLICAÇÕES NA POLPA: REVISÃO DE LITERATURA

Childhood dental trauma is common, especially in the 2-7 age group, and affects the upper central incisors more due to their exposure in impact situations. When the trauma involves the dental pulp, the treatment is to preserve the vitality of the tooth, with pulp capping and pulpotomy procedures being the most recommended. Currently, there has been a shift from invasive practices to conservative techniques in order to minimize long-term damage and improve the child's prognosis. The International Association of Dental Traumatology (IADT) guidelines contribute to this conservative approach, affirming the importance of immediate treatment and follow-up to avoid complications. The objective of this study is to demonstrate the implications of dental trauma in childhood, as well as how the pulp reacts to trauma. This literature review is based on articles published between 2014 and 2024, searched in the Scielo, Pubmed, Google Scholar and Periódico Capes databases. It was possible to conclude that, when subjected to trauma, the affected tooth may present some pulp responses, with pulp necrosis was the most frequent alteration.

Five-year retrospective analysis of Bakri balloon tamponade for obstetric haemorrhage and patient survey at a single tertiary centre

Background Intrauterine balloon tamponade (IUBT), specifically the usage of Bakri balloon tamponade (BBT), is an effective conservative management technique for postpartum haemorrhage (PPH). The primary objective was to evaluate local guidelines and contribute to evidence regarding ideal duration for BBT. The secondary objectives were to consider impacts on maternal-foetal wellbeing, and optimise healthcare efficiency by reducing length of ICU admissions. Methods This five-year retrospective case series analysed 132 cases of obstetric ICU admissions requiring Bakri balloon insertion for PPH within our centre. Additionally, a prospective patient experience survey was conducted over six-month period, involving 22 obstetric patients who required unplanned ICU admissions. Results Bakri balloon insertion was successful in 95%, whilst 5% experienced failure, necessitating further interventions (uterine artery embolisation) or return to theatre (hysterectomy). The success group demonstrated significant reductions in median blood loss (1.8 L vs. 2.5 L, p = 0.016) and difference in median duration of BBT (18.3 vs. 3.92 hours, p = 0.001). The prospective patient survey revealed a high level of satisfaction of care. Approximately 50% breastfed prior to discharge, on average commencing 23.4 hours post-delivery. This study demonstrates a high success rate of BBT, with failures typically occurring within median duration 3.9 hours. Conclusions Considering the separation of mother from baby during the Bakri balloon’s presence in ICU, we propose timely removal at around six hours, as failures are unlikely post this timeframe, or nursing these women in a neonatal care setting to facilitate earlier mother-baby bonding.

Comparative analysis of Roux-en-Y cystojejunostomy versus conservative surgical strategies for giant hepatic hydatid cysts: A retrospective study

BackgroundThis retrospective study addressed the challenge of postoperative biliary fistula, a common complication observed after surgical management of giant hepatic hydatid cysts. The primary objective was to compare the efficacy and safety of conservative surgical techniques versus prophylactic Roux-en-Y cystojejunostomy (R-en-Y CJ) in addressing residual cavity. MethodsRetrospective analysis was conducted on patients who underwent surgical intervention for giant hepatic hydatid cysts with cysto-biliary communication from July 2021 to Jan 2024. Preoperative laboratory tests, imaging studies, surgical procedures, and postoperative outcomes were reviewed from medical records. Results32 patients who underwent surgery for giant hepatic hydatid cysts were included. There were 19 (59.38%) female patients, with a mean age of cohort was 39.13 years. The patients were divided into two groups with respect to the treatment modality: Group A (n = 14), treated with conservative surgical techniques and R-en-Y CJ, and Group B (n = 18), treated with conservative surgical methods. The overall cavity-related complications occurred in 9/18 (50%) in Group B, whereas 2/14 patients (14.29%) in Group A during the follow-up period (p < 0.05). ConclusionR-en-Y CJ is an effective and safe surgical procedure for tackling residual cavities in giant hepatic hydatid cysts with cysto-biliary communication.

The comparative effectiveness of pelvic floor muscle training and hypopressive breathing techniques for pelvic organ prolapse: A systematic review and pooled analysis of randomized controlled trials

BackgroundPelvic floor (PF) disorder affects 25 ​% of females, often progressing to Pelvic Organ Prolapse (POP). PF muscle training (PFMT) and hypopressive breathing (HB) are conservative techniques used to repair pelvic muscles. This study analyzes the comparative efficacy of PFMT and HB for POP. MethodsA systematic review was conducted and seven records were included in the pooled analysis, which compared PF outcomes between HB and PFMT. ResultsPFMT (d ​= ​2.14 and d ​= ​1.07) demonstrated a larger effect size compared to HB (d ​= ​1.24 and d ​= ​0.78) for sEMG contractility and the Modified Oxford Scale, respectively. The Pelvic Floor Disability Index (PFDI-20) found a lower effect size of PFMT (d ​= ​0.558) compared to HB (d ​= ​0.961). ConclusionsPFMT was found to improve PF strength (Oxford) more than HB, while HB had a greater effect on quality of life (PFDI-20). Results were insignificant for contractility.

Botulinum Toxin for the Treatment of Raynaud's Conditions of the Hand: Clinical Practice Updates and Future Directions.

Raynaud's conditions of the hand, referred to commonly as Raynaud's phenomenon, both primary and secondary, represents a spectrum of disorders affecting the digits, characterised by recurrent episodes of vasospasm that result in a triad of symptoms: pain, pallor, and cyanosis. Various therapies, ranging from conservative hand therapy techniques to surgical sympathectomy, have been explored with inconsistent results. Recently, the local administration of botulinum toxin type-A (BTX-A) has re-emerged as a treatment option for this condition. This review delves into the mechanistic pathways of BTX-A therapy, optimal dosing concentrations, administration techniques, and its safety profile. A critical analysis of published studies to date demonstrates varied clinical efficacy of BTX-A in Raynaud's conditions based on patient-reported outcome measures and objective measures of outcomes assessment. Thus, in order to accurately assess the clinical effectiveness of BTX-A in future robust studies, this review emphasises the importance of streamlining patient selection to minimise heterogeneity in disease severity, optimising recruitment to ensure adequate statistical power, and establishing sensitive outcome measures to monitor response and discern treatment efficacy. Additionally, addressing concerns such as minimising antibody resistance, extending the duration of treatment effects on tissues, and exploring new modalities to assess hand perfusion will be focal points for future research and BTX-A drug development.

A Conservative Technique for Fractured Implant Abutment Screw Retrieval on an Internal Connection Implant: Proof of Concept.

Broken screw removal from the implant connection is a common but challenging process. Several proposed methods and technical solutions may result in unsuccessful removal; thus, a novel, more conservative, risk-free method is proposed as a first attempt. The proposal is to use a silicon restoration holder to be twisted counterclockwise on the dried surface of the broken fragment inside the implant connection. This method, within the limitations of a minimal case series, yielded 100% results; however, despite previous attempts with less conservative techniques, this approach showed no efficacy. This article aims to promote the use of silicon restoration holders as a minimally invasive first attempt at broken screw retrieval treatment before considering other options.

Single Versus Separate Incisions in Oncoplastic Breast Surgery Techniques

Abstract Background Patient concerns with aesthetics have prompted the improvement of oncoplastic surgical approaches. It has been shown that the aesthetic success in breast malignancy surgical treatment leads enhanced sexual and social recovery. In this study a prospective comparison between cohorts of early-stage breast cancer patients treated with oncoplastic breast surgery. The first cohort will be treated with the single incision approach and the second cohort will be treated by the conventional breast conservative technique, which will be performed with double incision (one for the tumour resection and the other for the axillary dissection). Objective to compare between single incision &amp; separate incisions in approach to axillary lymph nodes in oncoplastic breast surgery. Patients and Methods This is a prospective cohort comparative study between single incision &amp; separate incisions in approach to axillary lymph nodes in oncoplastic breast surgery. This study will be conducted at breast surgery unit at Ain Shams University Hospitals and Maddi Military Complex starting from June 2022 to June 2023. Approval of the Ethical Committee and written informed consent from all participants will be obtained. Results There was significant no statistical difference in both group as regards the operative timing, seroma and the hospital stay but there is a statistical difference regarding hematoma between the two groups. In our study, 86.7% of the patients attained good to excellent cosmetic outcomes (70% as excellent and 26.7% as good) regarding single incision and 79.7% of the patients attained good to excellent cosmetic outcomes (65% as excellent and 26.7% as good) regarding separate incision. High cosmetic outcome was obtained as the patients were satisfied with presence and shape of their breasts relatively. Conclusion The choice of the oncoplastic technique is mainly based upon the location of the tumor, size of the breast and distance of the tumor from the nipple areola complex. So all cases should be adequately reviewed in order to tailor the decisions for every single case. There is statistically difference between Single incision in breast cancer lesion and separate incision as regards hematoma and the cosmetic outcome.

Insights into upper blepharoplasty: Conservative volume-preserving techniques.

This editorial commentary critically examines the systematic review by Miotti et al, which discusses the evolving trends in upper lid blepharoplasty towards a conservative, volume-preserving approach. The review emphasizes the shift from traditional tissue resection to techniques that maintain anatomical integrity, paralleling broader trends in panfacial rejuvenation. Miotti et al delve into the nuances of fat pad management, advocating for conservation over reduction to sustain natural contours and improve long-term aesthetic outcomes. This perspective is supported by comparative studies and empirical data, such as those from Massry and Alghoul et al, highlighting the benefits of conservative approaches in terms of patient satisfaction and aesthetic longevity. The review also stresses the importance of surgeon discretion in adapting procedures to diverse patient demographics, particularly in addressing distinct features such as the Asian upper eyelid. However, it identifies a significant gap in long-term comparative research, underscoring the need for future studies to substantiate the safety and efficacy of these minimalist techniques. Overall, Miotti et al.'s work contributes profoundly to the discourse on personalized, conservative cosmetic surgery, urging ongoing research to refine and validate surgical best practices in upper eyelid blepharoplasty.

Upper Extremity Stress Fractures.

Stress injuries are often missed secondary to their insidious onset, milder symptoms, and subtle or initially absent findings when imaged. This review aims to provide strategies for evaluating and treating upper extremity stress fractures. This article outlines the classic presentation of each fracture, the ages during which these injuries often occur, the relevant anatomy and biomechanics, and the mechanism of each injury. Diagnostic imaging and management principles are also discussed, including the use of conservative versus surgical management techniques. Upper extremity stress fractures are often mild injuries that resolve with conservative management but can lead to more serious consequences if ignored. Given their increasing incidence, familiarity with diagnosis and management of these injuries is becoming increasingly pertinent.

Evaluating Treatment Modalities for Reducing Recurrence in Central Giant Cell Granuloma: A Narrative Review.

Treating central giant cell granuloma (CGCG) is challenging due to high recurrence rates and variable therapy responses. This study examines the efficacy of various treatments in reducing CGCG recurrence. A literature review explored outcomes of surgical excision, curettage, intralesional corticosteroid injection, and adjuvant therapy, considering factors like lesion location, size, and histological features. Aggressive surgical techniques such as en bloc resection were found to potentially lower recurrence rates compared to conservative approaches. However, treatment should be tailored to individual patient needs. Further research is needed to confirm these findings and improve treatment strategies. A concise literature review was conducted using PubMed, MEDLINE, and Google Scholar, focusing on papers published from 1986 to 2024. Search terms included "central giant cell granuloma", "recurrence", "treatment modalities", and "surgical excision". Studies reporting recurrence rates and treatment outcomes for CGCG were analyzed. Twenty-nine studies were reviewed, including six studies on surgical excision and curettage, eight studies on intralesional corticosteroid injections, six studies on calcitonin therapy, five studies on interferon-alpha therapy, and four studies on the therapy with denosumab. Analysis indicated that aggressive surgical treatments like en bloc resection were associated with lower recurrence rates compared to conservative methods. Predictors of recurrence included lesion size (>3 cm), location (mandible), and aggressive histopathological features. Aggressive surgical excision combined with nonsurgical methods may lower recurrence rates, while conservative techniques remain viable in some cases. Further prospective research is needed to validate these findings and enhance CGCG treatment options.

Steri-Strip Sling Technique - A Simple Procedure for the Management of Ingrown Toenails - A Prospective Study.

Ingrown toenail is a nail disorder that commonly affects great toenails. Surgical modalities are commonly used as first-line treatment. A conservative approach is preferable as surgical procedures lead to pain and affect routine activities. Our aim is to study the efficacy of a new conservative technique using steri-stripTM for the treatment of mild to moderate ingrown toenails as an outpatient procedure. Fifty patients presenting with stage 1-2 ingrown toenails were treated with the 'steri-strip sling technique'. Steri-stripTM is inserted between the disto-lateral edge of the nail plate and nail fold and secured with an elastic bandage. The dressing is kept till the nail edge grows over the nail fold and stops penetrating the skin. Patients were reviewed every week for a month after the treatment and monthly thereafter. The final result was assessed at 6 months. The success of treatment was assessed clinically and by patient satisfaction levels. Fifty patients were treated and followed up. Immediately after the procedure, all patients reported significant relief in pain. After 6 months, 46 out of 50 patients were satisfied with the treatment and showed no recurrence. No complications were reported. The 'Steri-stripTM sling technique' is a simple and effective outpatient procedure for the management of mild to moderate ingrown toenails.

Failed primary repair of blunt duodenal injury managed by tube duodenostomy, gastrojejunostomy and a feeding jejunostomy: a case report

BackgroundThe worldwide increase in road traffic crashes and use of firearms has increased the incidence of duodenal injuries. Upper gastrointestinal radiological studies and computed tomography (CT) in resource settings may lead to the diagnosis of blunt duodenal injury. Exploratory laparotomy remains the ultimate diagnostic test if a high suspicion of duodenal injury continues in the face of absent or equivocal radiographic signs. Although the majority of duodenal injuries may be managed by simple repair, high-risk duodenal injuries are followed by a high incidence of suture line dehiscence and should be treated by duodenal diversion.Case presentationWe report a case of a failed primary repair of a blunt injury to the second part of the duodenum (D2) in a 24-year-old African man. This was successfully managed by a tube duodenostomy, a bypass gastrojejunostomy and a feeding jejunostomy in a low resource setting.ConclusionsDetailed knowledge of the available operative choices in duodenal injury and their correct application is important. When duodenal repair is needed, conservative repair techniques over complex reconstructions should be utilised. The technique of tube duodenostomy can be successfully applied to cases of large defects in the second part of the duodenum (D2), failed previous repair attempts and with defects caused by different aetiology. It may remain especially useful as a damage-control procedure in patients with multiple injuries, significant comorbidities and/or haemodynamic instability.

Conservative treatment of intraperitoneal bladder perforations: a conscious choice or forced measure

Intraperitoneal traumatic perforations of the bladder of any origin (e.g., external trauma, iatrogenic injuries) and spontaneous ruptures are conditions that, according to the canons of surgery, require emergency surgical intervention by one or another access. However, some studies have indicated the possibility of conservative management of such patients — both adults and children. A review of publications describing the results of conservative treatment of patients with intraperitoneal bladder perforations was performed. Overall, 2,679 publications related to intraperitoneal perforations of the bladder were found in the available scientific databases, of which only 72 focused on issues of conservative treatment. In 13 of them, the possibility of such an approach is denied, but without reference to their own material. Analysis of the literature demonstrated that conservative management of intraperitoneal perforations of the may be feasible in certain circumstances, sometimes being a crucial measure. Indications for conservative treatment techniques include the absence of peritonitis, small perforation size, and short periods from the moment of perforation. However, all these indications are in the nature of opinions and assumptions and are not part of algorithmic tactics. The effectiveness of this approach remains unclear. The frequency of unsatisfactory outcomes ranges from 10% to 50%, which indicates the inappropriateness of conservative treatment. With the small number of studies and conflicting results obtained prohibits us to consider this technique as the method of choice for treating patients with intraperitoneal perforations of the bladder.

Microhardness and characterization of human dental tissue after application of enzymatic chemical agents: In vitro study.

The use of enzymatic chemical agents are papain-based materials used in the selective removal of decayed dentin tissue, assisting in conservative techniques and reducing the chances of accidental pulp exposure. A research protocol was subjected to and approved by an Ethics Committee. Using a reporting guide for laboratory studies (CRIS). Healthy human teeth comprised the produced dentin discs subjected to polishing and washing in an ultrasonic bath. Next, the discs received material application according to the experimental groups: water-soluble gel for two minutes, 37% phosphoric acid for 15 seconds in dentin and 30 seconds in enamel, Papacárie Duo (PD) for 30 seconds and two minutes, and Brix 3000 (BX) for two minutes and 30 seconds. The measurement of material pH used solutions at concentrations of 0.1 ml and 2.7 ml prepared for each enzymatic agent. Then, a bench pH meter (n=10) and pH indicator strips determined pH values. The discs underwent the Knoop hardness test (n=10). The sample calculation was performed using the GPower software with α = 0.05, effect 0.63 and power of 95%. Descriptive statistical analysis was carried out for pH, one way ANOVA supplemented by Tukey for knoop hardness and Spearman correlation for pH measurement techniques. The enamel hardness findings indicated that, after material application, ECAs do not statistically differ from water-soluble gel (p<0.05). The dentinal hardness analysis presented a statistical difference in phosphoric acid from the other groups (p<0.05). In the pH test, BX values were lower (4.37 ± 0.01) than PD (4.85 ± 0.06). The groups statistically differed (p<0.05). ECAs for removing decayed dentin tissue did not significantly alter the hardness of enamel and dentin, removal of the smear layer is time-dependent and presents acidity. Key words:Dental caries, Hardness, Dental materials, Papain.

A hybrid FEM-IBM-level set algorithm for water entry of deformable body

Water entry of deformable bodies has been investigated extensively despite the major challenges in precise simulations of the whole physical process. Inspired by the basic idea of immersed boundary method (IBM), a hybrid FEM-IBM-level set algorithm is proposed where structural compliance is considered. The flow is described by Navier-Stokes equations with an added body force while the drastically moving object of arbitrary geometry is represented by several Lagrangian points on solid boundary. The direct forcing IBM is enhanced and coupled with finite element method (FEM) to facilitate simulation of severe fluid-structure interactions. Consequently, the added body force is calculated implicitly based on the exact velocity boundary condition with divergence-free condition ensured simultaneously. The improved conservative level set technique is adopted for accurate depiction of instantaneously distorted water surface, and the strongly coupled system is resolved iteratively through a partitioned scheme. Examples including sedimentation of a disk, water entry of deformable wedge and cylindrical shell are performed for validation. Specifically, hydroelastic impact of a three-dimensional conical shell is investigated, and the influence factors of entry dynamics are discussed. The results demonstrate the reliability and great potential of present algorithm for practical applications in ocean engineering, naval architecture and military engineering, etc.

Safeguarding reverse osmosis membrane integrity in drinking water production: A pilot study using 2 native bacterial communities and viruses in surface water as integrity indicators

Water treatment train including a reverse osmosis barrier is capable of producing high-quality water coupled with microbial safety. However, analytically proving this with log removal value (LRV) > 3 has remained a challenge. Conservative techniques that quantify salt or sulfate ion passage as virus surrogates are currently used to credit the membrane system for its microbial removal capacity. These methods are insensitive, and it is now understood that the transport mechanism correlation between these surrogates with the actual passage of viruses is weak. There is also a huge gap between the current log credit assigned (using spiking of surrogates in feed) and the actual log removal that can be proven in the drinking water plant. In this paper, we introduce two techniques that exploit the high concentration of microbial communities in fresh surface water by quantifying bacteria through flow cytometry (FC) and native viruses through qPCR assays. These two methods are compared to LRV of conductivity, TOC, and fluorescent markers. That high concentration of bacterial community allowed for LRV > 4 by flow cytometry in an intact module. After inflicting damage with a 1.5 mm defect, the FC method detected the damage, and a bacterial cell count >103 cell count/ml was measured in the permeate, while conductivity lacked sensitivity to monitor any integrity loss. Furthermore, after chlorine exposure to the membrane, both bacteria and virus detected no leakage, proving the membrane's intactness and also demonstrating the effect of chlorination on the passage of small solutes. The implementation of the two microbial quantifying methods in full-scale water treatment plants facilitates higher sensitivity in membrane integrity loss than currently used methods.

Treatment of children with fractures of the distal metaepiphysis of the radius: A literature review

BACKGROUND: Fractures of the distal metaepiphysis of the radius are among the most common injuries in pediatric patients. This results from the peculiarities of the anatomical structure and structure of the radial tissue in this area. AIM: This study aimed to analyze the literature on the treatment of children with fractures of the distal metaepiphysis of the radius. MATERIALS AND METHODS: Literatures on the treatment of children with fractures of the distal metaepiphysis of the radius were extracted from PubMed, eLibrary, and Google Scholar without language restrictions for the period from 1990 to 2024. RESULTS: In fractures of the distal metaepiphysis of the radius without displacement, the limb is immobilized. Displaced fractures require closed reduction and/or surgical treatment. For the treatment of stable fractures, specialists adhere to conservative techniques. The method of choice for the surgical treatment of unstable fractures should be minimally invasive osteosynthesis. The current gold standard for the surgical treatment of fractures of the distal metaepiphysis of the radius in children is closed reduction and intramedullary metal osteosynthesis with Kirschner wires, followed by plaster cast application. CONCLUSIONS: Currently, no consensus has been reached on the method of choice for the surgical treatment of fractures of the distal metaepiphysis of the radius in children. The results of treating children using the presented surgical techniques are contradictory, and high risks of developing intra- and postoperative complications are noted. Thus, conducting more research in this area and developing new and most effective surgical methods that can reduce the risk of complications and optimize the rehabilitation process for these patients remain relevant.

Standardized approach to the conservative surgery of hepatic cystic echinococcosis: A prospective study.

Surgery is the mainstay of hepatic cystic echinococcosis (HCE). The conservative surgery of HCE carries a non-negligible risk of recurrence and significant morbidity, dominated by Deep Surgical Site Infections (DSSI). To address these issues, we have improved and standardized this technique, which could reduce complications and achieve better postoperative outcomes. We conducted a prospective study from June 2017 to June 2022 involving of patient operated using a standardized open technique for uncomplicated HCE at Habib Bourguiba University Hospital, Sfax, Tunisia. The aim was to obtain results at least similar to radical management in terms of DSSI. Patients with large cystobiliary fistulas or patients with complicated cysts were excluded. Fifty patients with 106 cysts were operated using the standardized technique comprising of liver mobilization, intraoperative ultrasound, systematic methylene blue injection to detect cystobiliary fistulas and omentoplasty. The median age of the patients was 44(semi-interquartile range: 16) years. The main symptom described by the patient was pain in 43 cases (86%). An abnormal liver test was found in 20 cases (40%). On imaging studies, the cyst had a median size of 7.4(3.0) cm. Cyst of the hepatic dome accounted for 38 cases (35.8%) with most cysts being situated in the right hemi-liver. Visual inspection of the cavity and Methylene blue testing allowed for the discovery of 57 cysts (53.7%) that had cystobiliary fistulas that were sutured. Omentoplasty was performed in 77 cysts (72.6%). Postoperatively, only 2 cases (1.9%) developed a DSSI in the form of an external bile leak with resolved with conservative management. No case of recurrence was found after a median follow-up of 24 months. The standardized conservative surgical technique, in selected patients, shows promise in reducing DSSI rates and overall morbidity, and achieve as equally good result as radical management.