BACKGROUND: Nonparasitic benign hepatic cysts are relatively rare, and are usually detected fortuitously while investigating a patient for some other illness. However, they may reach huge proportions and present as an upper abdominal mass. With the advent of laparoscopy, a minimally invasive technique is available to manage these cases, which is described along with results and a discussion of the concerned literature. METHODS: Since 1995, 27 patients underwent cyst fenestration at our institution. The team setup, port placement, instruments and technique are described. RESULTS: All of our patients had a single cyst. Of the 27 patients, 17 were symptomatic with the most common complaint being upper abdominal distension and pain. Twenty patients had a right-sided cyst. In 16 patients, omentopexy was done to deal with the residual cavity. Eleven patients underwent simultaneous cholecystectomy. The average operating time was 72 minutes. There have been no recurrences after an average follow-up period of 7.2 years. CONCLUSIONS: Laparoscopic management of congenital hepatic cysts has become the new gold standard, associated with minimum morbidity and good long-term outcome.
BACKGROUND: Nonparasitic benign hepatic cysts are relatively rare, and are usually detected fortuitously while investigating a patient for some other illness. However, they may reach huge proportions and present as an upper abdominal mass. With the advent of laparoscopy, a minimally invasive technique is available to manage these cases, which is described along with results and a discussion of the concerned literature. METHODS: Since 1995, 27 patients underwent cyst fenestration at our institution. The team setup, port placement, instruments and technique are described. RESULTS: All of our patients had a single cyst. Of the 27 patients, 17 were symptomatic with the most common complaint being upper abdominal distension and pain. Twenty patients had a right-sided cyst. In 16 patients, omentopexy was done to deal with the residual cavity. Eleven patients underwent simultaneous cholecystectomy. The average operating time was 72 minutes. There have been no recurrences after an average follow-up period of 7.2 years. CONCLUSIONS: Laparoscopic management of congenital hepatic cysts has become the new gold standard, associated with minimum morbidity and good long-term outcome.
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