Laparoscopic treatment of liver cysts.

Symptomatic simple liver cysts should be treated. In this report we describe the results of a straightforward, well-tolerated laparoscopic operation for this condition. Between 1990 and 1996 we performed 19 laparoscopic liver cyst excisions. The exposed portion of the cyst wall was excised and a piece of omentum was secured into the remaining cyst cavity to prevent recurrence. The average age of the patients was 65 years (range 30 to 81 years). Eight patients (42%) had single simple cysts, nine patients (47%) had multiple simple cysts, and two patients (11%) had polycystic liver disease. Fifty-three percent of the patients had previous abdominal operations, 47% had undergone previous needle aspirations, and one had previously undergone unsuccessful laparoscopic cyst decompression elsewhere. The indications for surgery included abdominal pain, mass, early satiety, malaise, bloating, and shortness of breath. Two patients underwent concurrent cholecystectomies, and one patient underwent concurrent laparoscopic Nissen fundoplication. Follow-up, which averaged 32 months (range 3 to 68 months), is complete in all patients. There was one treatment failure among the patients with simple cysts. Both patients with polycystic liver disease have had recurrent symptoms. The laparoscopic approach to simple liver cysts is relatively straightforward, and if certain technical principles are adhered to, the success rate is very high.