Nonparasitic Liver Cysts Research Articles

Sleeve Gastrectomy And Liver Cyst Unroofing In Morbid Obesity With Multiple Liver Cysts: A Case Report

Background: Obesity has become a major global health issue which leads to various complications, including hepatic diseases. However, we found a rare case of morbid obesity and symptomatic multiple liver cysts. Aim: This article aims to represent a rare case of morbid obesity and multiple liver cysts surgically managed by sleeve gastrectomy and liver cyst unroofing which were performed in a single surgery. Case report: 41-year-old female presented with morbid obesity and blunt intermittent abdominal pain in the right upper quadrant. Stage II hypertension, tenderness on the right upper quadrant of the abdomen and epigastrium were found in clinical assessment. Lipid profiles were shown to be elevated. Abdominal CT revealed fatty liver and multiple cystic lesions in all hepatic segments. Discussion: Non-parasitic liver cysts affect 2-18% of the global population, with a higher prevalence in females possibly due to hormonal factors. Obesity is associated with hormonal alterations, potentially leading to increased secretion of FSH and LH. Conclusion: Sleeve gastrectomy and liver cyst unroofing may be considered as a treatment strategy for patients with morbid obesity and multiple liver cysts.

Significance of morphological studies in the diagnostics of bilial intraepithelial neoplasia in nonparasitic liver cysts

Biliary intraepithelial neoplasia (BilIN) according to modern data is considered as an obligate precancer of the bile ducts. As BILIN progresses, cholangiocarcinoma often develops, characterized by a low five-year survival rate. The aim of this work is to describe the morphological characteristics of BilIN in the epithelium of nonparasitic liver cysts. The material is described after primary and repeated (15) surgical interventions in 99 patients. The morphological manifestations of intraepithelial neoplasia in non-parasitic dysontogenetic liver cysts were studied, their role in the development of liver cholangiocarcinoma was established.

OGBN P18 Laparoscopic Deroofing of a Liver Cyst

Abstract Background Laparoscopic deroofing is considered to be part of standard practice for simple nonparasitic liver cysts. Methods This “how to” video demonstrates an approach to the laparoscopic deroofing of a large, nonparasitic liver cyst. After the placement of umbilical, epigastric and a working right upper quadrant port, the cyst is aspirated. This allows easier handling of the cyst. A cystostomy is then created and a LOTUS or Harmonic scalpel is used to cut thru the cyst wall.Further suctioning of the cyst contents allows the cyst to collapse which facilitates handling of the tissue. Complete resection of the cyst can be achieved by dissecting close to the cyst wall which is then placed into an endobag prior to removal. It is important to ensure good haemostasis at the liver. Omentum may be placed in larger cavities to reduce dead space and prevent fluid collection. Results This patient made a good postoperative recovery and cytology and histology confirmed benign cyst. Conclusions This video demonstrates one approach to the laparoscopic deroofing of a large, simple, nonparasitic liver cyst.

The application of titanium nickelide cryodestructors in the surgery of cystes and hemangiomas of the liver

The possibility of using titanium nickelide (TiNi) cryoapplicator in the surgery of nonparasitic cysts and liver hemangiomas was study.Material and methods. The analysis of the results of surgical treatment of patients with the use of TiNi cryoapplicator was carried out in 26 patients with nonparasitic liver cysts and in 31 patients with liver hemangiomas of various localization and diameter.Results. It was proved that the use of a TiNi cryoapplicator is as effective as a stationary cryoinstallation with a constant supply of a cryoagent (liquid nitrogen).Conclusion. The use of TiNi cryoapplicator increases the effectiveness of the action on cysts and hemangiomas of the liver, causing their cryodestruction and preventing the recurrence of these diseases, reduce blood loss and reduce trauma when using laparoscopic cryoprobes. In addition, when using the open access of Merzlikin– Paramonova, it becomes possible to manipulate with less trauma in the area of the diaphragmatic surface of the organ and the caval gates of the liver, which are difficult to access for surgical intervention from traditional incisions, especially when the pathological process is located in 7–8 segments of the liver.

MINIMALLY INVASIVE METHODS FOR TREATING LIVER CYSTS

Despite current advances in minimally invasive surgery, the diagnosis and treatment of liver cysts of non-parasitic genesis remains a controversial issue.
 The aim of the study is to improve the results of surgical treatment of patients with liver cysts of non-parasitic genesis by complex application of mini-invasive diagnostic and surgical methods.
 Materials and methods: patients were carried out clinical, laboratory, instrumental methods of examination, during which liver cysts were identified. Patients were prescribed painkillers before and after puncture to prevent pain syndrome. Puncture was performed under local anesthesia. After the evacuation of the contents, 96 % ethyl alcohol was injected into the cavity. Pig tail 6 F catheters were used for drainage. The average drainage time for liver cysts is (22 ± 1.6) days. Indications were determined for performing the puncture under the control of sonography, laparoscopic method of treatment. Puncture-draining interventions were performed in 53 patients with non-parasitic liver cysts, of which ultrasound-controlled drainage was performed in 30 patients, and video laparoscopic drainage was performed in 23 patients.
 Results and discussion: postoperative period was more favorable in patients who used percutaneous puncture interventions. Immediately after percutaneous interventions under ultrasound control and from the second day after video laparoscopic operations and patients returned to their usual diet and volume of physical activity.
 Conclusions: thus, minimally invasive methods of surgical treatment of non-parasitic liver cysts have significantly improved the rehabilitation of this group of patients.

Current status and progress in the treatment of congenital liver cyst

Liver cyst is a relatively common benign liver disease. According to the cause of the disease, it can be divided into two types: non-parasitic liver cyst and parasitic liver cyst. Congenital liver cyst is the most common non-parasitic liver cyst in clinical practice, also known as true cyst, which mainly include simple liver cyst and polycystic liver diseases (PLD). In recent years, with the popularization of ultrasound and other examinations, the detection rate of liver cyst has increased year by year, but there is no unified consensus on the treatment of liver cysts. This article reviews the conservative treatment, puncture drainage, aspiration sclerotherapy, surgical treatment and other treatment options for congenital liver cysts, as well as the technological progress in recent years.

ЛАПАРОСКОПИЧЕСКОЕ ЛЕЧЕНИЕ ВРОЖДЕННЫХ НЕПАРАЗИТАРНЫХ КИСТ ПЕЧЕНИ У НОВОРОЖДЕННЫХ

Congenital nonparasitic liver cysts in newborns are rare. Surgical excision of these formations is necessary to prevent complications. Reports of laparoscopic treatment of simple liver cysts in children are also rare. Authors present a series of endosurgical treatment of patients, numbering 3 children and coming from a single surgical center, and compare it with the literature data known to date. Data of 3 patients with nonparasitic liver cysts were collected at the Center for Neonatal Surgery, beginning in 2014. The analysis of the patient's demographic data and parameters of hepatic cysts (location, histological structure) is performed. Early and long-term results of laparoscopic operations were studied. All patients were newborns: 2 girls and 1 boy. The primary diagnosis was set during prenatal ultrasound examination. In all patients a complete resection of pathological liver formations was performed using laparoscopy. There were no complications during early postoperative period. In the long-term follow-up period, there were no disease recurrences. The study presents one of the largest series of laparoscopic excision of nonparasitic liver cysts in newborns. The study revealed that laparoscopy is a safe and effective method of treating of congenital hepatic cysts.

The possibility of endovideosurgery treatment of the nonparasitic liver cysts

The possibility of endovideosurgery treatment of the nonparasitic liver cysts

Systematic review of laparoscopic fenestration and percutaneous sclerotherapy in the management of symptomatic nonparasitic simple liver cysts

Systematic review of laparoscopic fenestration and percutaneous sclerotherapy in the management of symptomatic nonparasitic simple liver cysts

Radiofrequency ablation in management of simple non-parasitic liver cysts

Purpose. Comparison of the long-term outcomes of the treatment of simple liver cysts by traditional and modified RFA methods.Materials and methods. From 2015 to 2018, US-guided RF ablation was used to treat simple nonparasitic hepatic cysts in 14 patients. There were 15 operated cysts in total. 7 patients of group A underwent standard RFA session without temperature restrictions. 7 patients of group B with localization of cysts closely to large vessels and bile ducts or the area of portal fissure, underwent RFA at 60 °C with preinjection of 10% NaCl solution into the cyst cavity. During the intervention, the temperature of the surrounding electrode tissue and the exposure time were recorded.Results. All patients underwent interventions satisfactorily; no complications were observed. In group A, the mean cyst diameter was 50.3 ± 15.2 mm, and the mean initial cyst volume was 77.09 ± 23.2 cm3. In group B, the mean cyst diameter was 61.8 ± 14.9 mm, and the mean initial cyst volume was 137.8 ± 39.2 cm3. After 3 months, the overall decrease in the volume of operated cysts on CT was in group A – 27.1%, in group B – 50.6%; after 6 months – 49.8% and 60.4%, respectively. After 12 months, similar indicators in group A amounted to 64.2%, in group B – 79.2%. 1.5 years after surgery, the volume of operated cysts in group A decreased by 65.2%, in group B by 91.2%; and after 2 years – by 68.9% and 93.6%, respectively. The total decrease of cyst volume at the last control in group B was 24.7% more than in group A. The decrease in cyst volume by more than 50% was noted in group A in 37.5%, in group B – in 85.7%. Complete reduction of the cyst cavity was noted in group A in 25%, in group B in 28.5%. The difference in the decrease of the cyst volumes between the groups after 2 years is statistically significant (p = 0.03), thus it can be concluded that a significantly more pronounced decrease in cyst volumes was observed in group B than in group A.Conclusion. Preinjection into the cystic cavity of a 10% solution of NaCl allowed to achieve a more pronounced decrease of the cystic cavities with the lower RFA temperature regime. At a temperature of 60 °C, the thermal damage minimally spreads to adjacent healthy liver tissue andis sufficient for the radical treatment of the cystic cavity. This makes possible to use the modified RFA method for cysts, located close to the large vessels and bile ducts.

Puncture methods of treatment of patients with fluid formations of the pancreas and liver

Summary. Diagnosis and treatment fluid formations of the liver and pancreas non-parasitic genesis remains a controversial issue, despite current advances in minimally invasive surgery. The aim of the study is to improve the results of surgical treatment of patients with fluid formations of the liver and pancreas non-parasitic genesis through the integrated use of mini-invasive methods of diagnosis and surgical treatment. Patients were carried out clinical, instrumental, laboratory methods of examination, in the course of which liquid formations were revealed. With the help of ultrasound of the apparatus the liquid structure was elucidated, then dopplerography determined the non-vascular zone for passing the puncture needle. For punctures we used special nozzles on the ultrasonic sensor. The puncture was performed under local anesthesia. Chiba-type needles were used for the puncture, and Pig tail catheters from 6 to 9 F were used for drainage. The timing of the puncture was determined individually, taking into account clinical and sonographic signs, with the average time of drainage of pancreatic cysts being 24 ± 4,3 days, and drainage of liver cysts – 32 ± 1,6 days. Indications for puncture under the control of sonography and laparoscopic treatment were determined. Puncture-draining interventions were performed in 53 patients with non-parasitic liver cysts, of which 30 patients were drained under ultrasound control, and 23 patients underwent video laparoscopic drainage. Also punctuation-drainage interventions were performed in 72 patients with pseudo-pancreatic cysts, of which ultrasonic drainage was performed in 48 patients, 24 patients had video laparoscopic drainage. In the case of puncture treatment of liver cysts and pancreas, narcotic analgesics were not used for pain relief. The postoperative period was more favorable in patients where percutaneous puncture interventions were used. Immediately after percutaneous interventions under ultrasound control and from the second day after videolaparoscopic operations, patients returned to their usual diet and volume of physical activity. Thus, comparing different methods of surgical treatment of non-parasitic fluid formations of the liver and pancreas it was established that application of puncture-draining methods allowed to improve significantly medical and social indices of this group of patients.

Surgical treatment for non-parasitic liver cysts improves quality of life

Background&purposeLiver cysts occur frequently. Most are harmless, however some carry a significant patient burden. Optimizing treatment strategy is complicated as needs differ between patients. The current study assesses the effect of surgery on quality of life (QoL) of patients with non-parasitic liver cysts. MethodsA retrospective cohort study of all patients who underwent surgery for non-parasitic liver cysts in three major Dutch medical centers from 1993 to 2017. Patient characteristics and surgery related variables were collected from the electronic patient file. QoL was measured before and after surgery using the EORTC QLQ-C30. Summary scores (SumSc) were calculated and compared to reference values of the general population. Multivariate analysis using logistic regression was performed for identifying outcome related factors. Increase of ≥ 10% in SumSc was defined as clinically relevant. Main findingsEighty-eight of 132 eligible patients (67%) completed two QoL assessments. Respondents demonstrated significant improvement in the global health status, on all 5 functional scales (all p ≤ 0.005), on all 9 symptom scales after surgery (all p < 0.05), and on SumSc (p < 0.001) to levels similar or better than the general population. Patients with complications demonstrated a significant QoL gain (p < 0.05), and reported a similar postoperative status compared to patients without complications (p = 0.74). QoL gain for patients who underwent open and laparoscopic cyst fenestration were similar (p = 0.08). Multivariate analysis of SumSc found mechanical complaints as significant factor for ≥ 10% SumSc increase (OR 0.11, 95% CI (0.02–0.55). ConclusionsSurgery is a safe and effective strategy to significantly improve QoL in patients with symptomatic liver cysts.

Laparoscopic Treatment of Congenital Nonparasitic Liver Cysts in Newborns.

Background: Congenital nonparasitic liver cysts in newborns are rare. Surgical excision of these formations is necessary to prevent complications. Reports of laparoscopic treatment of simple liver cysts in children are sporadic. We present a series of 3 patients with liver cysts treated laparoscopically in a single center. We added a short review of the literature. Methods: Data of 3 patients with nonparasitic liver cysts were collected at our center, from 2014 to 2019. Early and long-term results of laparoscopic operations were studied. Results: All patients were newborns, and of these, 2 were girls and 1 boy. The primary diagnosis was established during prenatal ultrasound examination. The laparoscopic approach was used in all patients. Complete resection of the cysts was achieved laparoscopically in all cases. Pathology reports were consistent with nonparasitic liver cysts. The early postoperative period was uneventful with prompt discharge. In the long-term follow-up period, there were no recurrences of the disease. Conclusions: The study presents one of the largest series of laparoscopic excision of nonparasitic liver cysts in newborns. We conclude that laparoscopy is a safe and effective method of treating of congenital hepatic cysts.

Endovideosurgery in treating large nonparasitic hepatic cysts

Background. Liver cysts despite their low prevalence are an important issue in surgical hepatology. Among the indicatiors of the problem are often on the one hand, an asymptomatic course and on the other hand, possible complications such as compression of vessels and bile ducts, suppuration with abscesses and their rupture leading to peritonitis.&#x0D; Material and methods. The article presents the experience of treating the patient with a large nonparasitic liver cyst, as well as the technical aspects of surgery and the immediate results of the treatment.&#x0D; Results. The use of endovideosurgical technologies in treating patients with large nonparasitic liver cysts reduces the length of hospital stays, minimizing postoperative complications, as well as the period of rehabilitation.&#x0D; Conclusion. The use of external drainage of nonparasitic liver cysts under the control of medical imaging methods is preferable in the presence of infectious complications of cysts as a preparatory stage for radical treatment. Laparoscopic treatment of patients with large nonparasitic liver cysts is characterized by the lowest complication and recurrence rates and for repeated surgical interventions.

Laparoscopic resection of multiple nonparasitic liver cysts

Laparoscopic resection of multiple nonparasitic liver cysts

Operative management of non-parasitic liver cysts – A single centre experience

Introduction: Non-parasitic liver cysts include Simple cysts, Multiple cysts in the setting of Polycystic disease and Cystic neoplasms. They are usually found as an incidental finding on imaging. Not more than 10-15% cause symptoms. Surgical management offers symptomatic relief with minimal morbidity. Methods: Retrospective analysis was made of patients with non-parasitic liver cysts who were managed surgically in the Institute of Surgical Gastroenterology, Madras Medical College over a period of 3 years. Patient demographics, symptoms, cyst characteristics, operative procedure, morbidity, mortality, length of hospital stay and histopathological diagnosis were analysed. Results: Between 2014 and 2017, 14 patients underwent surgery for symptomatic non-parasitic liver cysts. Majority were female. Mean age was 49 years. Abdominal discomfort was the predominant symptom. One patient had recurrent cyst. Preoperative diagnosis was simple cyst, multiple cysts and biliary cystadenoma in 8,4 and 2 patients respectively. The mean cyst diameter was 12.56 cm. Laparoscopic fenestration, open fenestration/partial excision and open resection were performed in 9,3 and 2 patients respectively. The recurrent cyst was diagnosed as choledochal cyst on histopathological analysis. Mean length of hospital stay was 6.71 days. Morbidity developed in two patients in the form of bile leak which was managed conservatively. There was no mortality. Conclusion: Laparoscopic fenestration is an effective treatment for symptomatic non-parasitic, non-neoplastic liver cysts. Open fenestration should be considered for recurrent cysts and those with difficult laparoscopic access. Resection is preferred for neoplastic liver cysts.

МОРФОГЕНЕТИЧЕСКИЕ ВАРИАНТЫ НЕПАРАЗИТАРНЫХ КИСТ ПЕЧЕНИ

Literature review reflects modern view on morphogenesis of nonparasitic liver cysts. Morphological characteristic and embryogenesis varies with different variants of dysontogenetic cysts are presented.

Лечебно-диагностическая тактика ведения пациентов с непаразитарными кистами печени

The article assesses the value of diagnostic methods for patients with non-parasitic hepatic cysts, justifies the tactics of patient management based on the results of the immediate postoperative period. Materials and methods: an analysis of the observation and treatment of 64 patients with non-parasitic liver cysts is presented, the immediate results of surgical treatment are reflected. Results: Ultasound investigation is noninvasive procedure with high value of diagnostic possibility. The use of laparoscopic operations reduces the time of treatment in the hospital, minimizing the value of complications. External drainage reduces the number of postoperative complications and the duration of treatment of the patients with infectious complications of non-parasitic hepatic cysts. Conclusions: the optimal method for diagnosing this pathology is CT. The use of external drainage of nonparasitic hepatic cysts under the control of medical imaging methods is preferable in the presence of infectious complications. Endovideosurgical treatment of non-parasitic hepatic cysts has the least number of postoperative complications. Open operations remain relevant in the presence of difficulties in the differential diagnosis.

Extended liver resection in a central biliary cystadenoma

Objective: Biliary cystoadenomas are rare, less than 5% of non-parasitic liver cysts and often confused with other more common cystic disease. Its premalignant potential indicates the need for a complete surgical resection. Video presentation of a central cystadenoma with bilateral vascular relations. Methods: 61 year old female with a cystic tumor involving segments 3,4b,5,7 and 8; diagnosed 5 years ago and followed up by ultrasound with slow growth. CT: multilocular cyst that compress bilaterally elements of hepatic hilum. MRI: 13 cm centrally located tumor extending cephalic from the liver caudate lobe to the dome, hypointense in T1, hyperintense in T2; in contact with pancreatic head and bilateral hepatic highland displacement. Results: Right extended hepatectomy was performed with good postoperative evolution. Discharge at 5th day. Pathology: mucinous cystic neoplasm of the liver with low-grade dysplasia, negative margins. Conclusion: Complete resection is the best treatment for biliary cystadenoma in order to avoid recurrence and malignant transformation. According to the anatomical location, the parenchymal characteristics and the liver remnant the best approach for a complete resection needs to the considered. Partial resections must be avoided.

THE ROLE OF MINIMALLY INVASIVE TECHNOLOGIES IN THE SURGICAL TREATMENT OF NONPARASITIC LIVER CYSTS

Aim. To assess the efficacy of minimally invasive procedures to improve the results of surgical treatment of nonparasitic liver cysts. Material and methods. The experience of treatment of 42 patients with nonparasitic liver cysts is presented, technical aspects and efficacy of minimally invasive methods in this category of patients are described. Results : using of an endovideosurgical method of treatment significantly reduces the time spent in hospital, minimizing postoperative complications. Long-term results of surgical treatment of nonparasitic liver cysts in the form of good cosmetic effect, absence of recurrences of the disease and clinical manifestations were improved. Conclusion . A laparoscopic treatment of nonparasitic liver cysts is characterized by the low number of complications, low frequency of relapses, and the absence of necessity for re-operation. The use of external drainage for nonparasitic liver cysts under the ultrasound supervision is preferable for infectious complications of liver cysts as a first stage before the radical surgical treatment.