BACKGROUND: The laparoscopic accessibility of congenital liver cysts located in the anterosuperior (VIII) and posterosuperior (VII) segments has been questioned for some time. In support of the laparoscopic approach, we here describe our minimally invasive technique in two patients with solitary congenital cysts located in the apex of liver segments VIII and VII, respectively. METHOD: Both patients were placed in the inverted Y position. Four trocars were used, their position depending on the location of the cyst. RESULTS: The segment VIII cyst was easily reached via this anterior approach, while the segment VII cyst required significant mobilization of the right liver lobe. In both cases a complete excision of the cystic roof was achieved using the harmonic scalpel. Without performing an omentoplasty no recurrences were observed after 20 and 28 months, respectively. CONCLUSION: Solitary cysts located in segments VII and VIII of the liver can be safely treated by laparoscopic unroofing. Cyst recurrences may best be prevented by a complete excision of the cystic roof with an adjacent rim of hepatic parenchyma.
BACKGROUND: The laparoscopic accessibility of congenital liver cysts located in the anterosuperior (VIII) and posterosuperior (VII) segments has been questioned for some time. In support of the laparoscopic approach, we here describe our minimally invasive technique in two patients with solitary congenital cysts located in the apex of liver segments VIII and VII, respectively. METHOD: Both patients were placed in the inverted Y position. Four trocars were used, their position depending on the location of the cyst. RESULTS: The segment VIII cyst was easily reached via this anterior approach, while the segment VII cyst required significant mobilization of the right liver lobe. In both cases a complete excision of the cystic roof was achieved using the harmonic scalpel. Without performing an omentoplasty no recurrences were observed after 20 and 28 months, respectively. CONCLUSION: Solitary cysts located in segments VII and VIII of the liver can be safely treated by laparoscopic unroofing. Cyst recurrences may best be prevented by a complete excision of the cystic roof with an adjacent rim of hepatic parenchyma.
Authors: Doo-Ho Lee; Jai Young Cho; Ho-Seong Han; Yoo-Seok Yoon; Dae Wook Hwang; Kyuwhan Jung; Young Ki Kim; Hong Kyung Shin; Woohyung Lee Journal: Ann Surg Treat Res Date: 2014-04-24 Impact factor: 1.859
Authors: Giovanni Dapri; Matteo Barabino; Pietro Carnevali; Ion Surdeanu; Jacques Himpens; Guy-Bernard Cadière; Vincent Donckier Journal: JSLS Date: 2012 Apr-Jun Impact factor: 2.172