TY - JOUR
T1 - Risk for laparoscopic fenestration of liver cysts
AU - Giuliante, Felice
AU - Vellone, Maria
AU - Nuzzo, Gennaro
AU - D'Acapito, Fabrizio
AU - Giovannini, Ivo
PY - 2003
Y1 - 2003
N2 - Background: Laparoscopic fenestration is considered the best treatment for symptomatic simple liver cysts.
Conversely, the laparoscopic approach for the management
of hydatid simple liver cysts is not widely accepted because of the risk for severe complications.
Despite improvement in imaging techniques, the probability
of preoperatively mistaking a hydatid liver cyst for a simple liver cyst remains about 5%. Therefore,
laparoscopic fenestration, planned for a liver cyst could be performed unintentionally for an undiagnosed hydatid liver cyst.
Methods: From January 2000 to January 2001, 15 patients
with a diagnosis of liver cyst underwent laparoscopy
for fenestration. In all cases preoperative serologic
and imaging assessment had excluded hydatid liver cyst.
To further exclude hydatid liver cyst, preliminary aspiration of the cyst with assessment of cystic fluid characteristics was performed.
Results: In two patients with presumedly simple liver
cyst, hydatid liver cyst was diagnosed instead at laparoscopy
by aspiration of cystic fluid. The procedure was converted to laparotomy with subtotal pericystectomy.
Conclusions: The risk of misdiagnosing a hydatid liver cyst for a simple liver cyst, especially in the presence of a
solitary cyst, should be considered before laparoscopic
fenestration is performed. Intraoperative aspiration of
cyst fluid before fenestration can minimize this risk, thus
avoiding severe intraoperative and late complications.
AB - Background: Laparoscopic fenestration is considered the best treatment for symptomatic simple liver cysts.
Conversely, the laparoscopic approach for the management
of hydatid simple liver cysts is not widely accepted because of the risk for severe complications.
Despite improvement in imaging techniques, the probability
of preoperatively mistaking a hydatid liver cyst for a simple liver cyst remains about 5%. Therefore,
laparoscopic fenestration, planned for a liver cyst could be performed unintentionally for an undiagnosed hydatid liver cyst.
Methods: From January 2000 to January 2001, 15 patients
with a diagnosis of liver cyst underwent laparoscopy
for fenestration. In all cases preoperative serologic
and imaging assessment had excluded hydatid liver cyst.
To further exclude hydatid liver cyst, preliminary aspiration of the cyst with assessment of cystic fluid characteristics was performed.
Results: In two patients with presumedly simple liver
cyst, hydatid liver cyst was diagnosed instead at laparoscopy
by aspiration of cystic fluid. The procedure was converted to laparotomy with subtotal pericystectomy.
Conclusions: The risk of misdiagnosing a hydatid liver cyst for a simple liver cyst, especially in the presence of a
solitary cyst, should be considered before laparoscopic
fenestration is performed. Intraoperative aspiration of
cyst fluid before fenestration can minimize this risk, thus
avoiding severe intraoperative and late complications.
KW - Laparoscopic fenestration
KW - Liver cysts
KW - Non-hydatid cysts
KW - Laparoscopic fenestration
KW - Liver cysts
KW - Non-hydatid cysts
UR - http://hdl.handle.net/10807/14614
U2 - 10.1007/s00464-002-9106-1
DO - 10.1007/s00464-002-9106-1
M3 - Article
VL - 17
SP - 1735
EP - 1738
JO - Surgical Endoscopy and Other Interventional Techniques
JF - Surgical Endoscopy and Other Interventional Techniques
SN - 0930-2794
ER -