A new technique for the laparoscopic treatment of simple hepatic cysts
Background: Simple hepatic cysts are commonly detected in the general population, both solitary and associated with Adult Dominant Polycystic Kidney Disease (ADPKD). Laparoscopic fenestration is a surgical option adopted as first-line treatment and to treat complications. The techniques reported in...
| Glavni autori: | , , , , , , |
|---|---|
| Format: | Članak |
| Jezik: | English |
| Izdano: |
Elsevier
2023-06-01
|
| Serija: | Surgery in Practice and Science |
| Teme: | |
| Online pristup: | http://www.sciencedirect.com/science/article/pii/S2666262023000177 |
| _version_ | 1827931785685630976 |
|---|---|
| author | Cinzia Bizzoca Felicia Fiore Fabrizio Aquilino Salvatore Fedele Maria Di Salvo Giuseppe Lucarelli Leonardo Vincenti |
| author_facet | Cinzia Bizzoca Felicia Fiore Fabrizio Aquilino Salvatore Fedele Maria Di Salvo Giuseppe Lucarelli Leonardo Vincenti |
| author_sort | Cinzia Bizzoca |
| collection | DOAJ |
| description | Background: Simple hepatic cysts are commonly detected in the general population, both solitary and associated with Adult Dominant Polycystic Kidney Disease (ADPKD). Laparoscopic fenestration is a surgical option adopted as first-line treatment and to treat complications. The techniques reported in the literature are associated with cyst recurrence in up to 41% of cases. Methods: From 2012 to May 2021, 19 symptomatic patients diagnosed with simple HCs underwent an innovative technique for laparoscopic fenestration, which includes simultaneous ethanol injection into the residual cavity. The median follow up was 57 (range 4-116) months. We retrospectively analysed symptomatic relief obtained in the short and long term as primary outcome. We also evaluated the postoperative outcome, recurrence and re-intervention rates. Results: 11 patients (of 19) were female (58 %), with a median age of 58 (range 31-78) years. Most patients (17 of 19) experienced relief of symptoms after intervention (89,5 %). Radiological recurrence occurred in 21% of patients; nevertheless, only one patient, affected by ADPKD, experienced clinical relapse with abdominal discomfort. No patient needed reintervention. There was no major morbidity (Clavien-Dindo III-IV) nor 90-day mortality. The technique allowed early removal of abdominal drainage (median 2.5 days). Conclusions: Laparoscopic fenestration of a simple hepatic cyst, with simultaneous ethanol injection, combines the advantages of the laparoscopic approach with those of injecting sclerosing agent. The described technique is associated with symptomatic relief and a favourable outcome in the postoperative period, as well as with good long term results. |
| first_indexed | 2024-03-13T06:58:11Z |
| format | Article |
| id | doaj.art-a2b9f653a053478f81d49b62a1f0ba6e |
| institution | Directory Open Access Journal |
| issn | 2666-2620 |
| language | English |
| last_indexed | 2024-03-13T06:58:11Z |
| publishDate | 2023-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Surgery in Practice and Science |
| spelling | doaj.art-a2b9f653a053478f81d49b62a1f0ba6e2023-06-07T04:49:48ZengElsevierSurgery in Practice and Science2666-26202023-06-0113100171A new technique for the laparoscopic treatment of simple hepatic cystsCinzia Bizzoca0Felicia Fiore1Fabrizio Aquilino2Salvatore Fedele3Maria Di Salvo4Giuseppe Lucarelli5Leonardo Vincenti6Department of General Surgery “Ospedaliera”. Polyclinic Hospital of Bari, Piazza G. Cesare, 11, 70124 Bari, Italy; Corresponding author: Cinzia Bizzoca, Via Martiri d'Avola 1/A, 70124 Bari, 00393282009615Department of General Surgery “Ospedaliera”. Polyclinic Hospital of Bari, Piazza G. Cesare, 11, 70124 Bari, ItalyDepartment of General Surgery. National Institute of Gastroenterology Saverio de Bellis, Research Hospital, via Turi 27, 70013 Castellana Grotte, Bari, Italy. via Turi 27, 70013 Castellana Grotte, Bari, ItalyDepartment of General Surgery. National Institute of Gastroenterology Saverio de Bellis, Research Hospital, via Turi 27, 70013 Castellana Grotte, Bari, Italy. via Turi 27, 70013 Castellana Grotte, Bari, ItalyDepartment of General Surgery “Ospedaliera”. Polyclinic Hospital of Bari, Piazza G. Cesare, 11, 70124 Bari, ItalyDepartment of Emergency and Organ Transplantation-Urology, Andrology and Kidney Transplantation Unit, University of Bari, 70124 Bari, ItalyDepartment of General Surgery “Ospedaliera”. Polyclinic Hospital of Bari, Piazza G. Cesare, 11, 70124 Bari, ItalyBackground: Simple hepatic cysts are commonly detected in the general population, both solitary and associated with Adult Dominant Polycystic Kidney Disease (ADPKD). Laparoscopic fenestration is a surgical option adopted as first-line treatment and to treat complications. The techniques reported in the literature are associated with cyst recurrence in up to 41% of cases. Methods: From 2012 to May 2021, 19 symptomatic patients diagnosed with simple HCs underwent an innovative technique for laparoscopic fenestration, which includes simultaneous ethanol injection into the residual cavity. The median follow up was 57 (range 4-116) months. We retrospectively analysed symptomatic relief obtained in the short and long term as primary outcome. We also evaluated the postoperative outcome, recurrence and re-intervention rates. Results: 11 patients (of 19) were female (58 %), with a median age of 58 (range 31-78) years. Most patients (17 of 19) experienced relief of symptoms after intervention (89,5 %). Radiological recurrence occurred in 21% of patients; nevertheless, only one patient, affected by ADPKD, experienced clinical relapse with abdominal discomfort. No patient needed reintervention. There was no major morbidity (Clavien-Dindo III-IV) nor 90-day mortality. The technique allowed early removal of abdominal drainage (median 2.5 days). Conclusions: Laparoscopic fenestration of a simple hepatic cyst, with simultaneous ethanol injection, combines the advantages of the laparoscopic approach with those of injecting sclerosing agent. The described technique is associated with symptomatic relief and a favourable outcome in the postoperative period, as well as with good long term results.http://www.sciencedirect.com/science/article/pii/S2666262023000177Hepatic CystLaparoscopic FenestrationEthanol InjectionLiver Surgery |
| spellingShingle | Cinzia Bizzoca Felicia Fiore Fabrizio Aquilino Salvatore Fedele Maria Di Salvo Giuseppe Lucarelli Leonardo Vincenti A new technique for the laparoscopic treatment of simple hepatic cysts Surgery in Practice and Science Hepatic Cyst Laparoscopic Fenestration Ethanol Injection Liver Surgery |
| title | A new technique for the laparoscopic treatment of simple hepatic cysts |
| title_full | A new technique for the laparoscopic treatment of simple hepatic cysts |
| title_fullStr | A new technique for the laparoscopic treatment of simple hepatic cysts |
| title_full_unstemmed | A new technique for the laparoscopic treatment of simple hepatic cysts |
| title_short | A new technique for the laparoscopic treatment of simple hepatic cysts |
| title_sort | new technique for the laparoscopic treatment of simple hepatic cysts |
| topic | Hepatic Cyst Laparoscopic Fenestration Ethanol Injection Liver Surgery |
| url | http://www.sciencedirect.com/science/article/pii/S2666262023000177 |
| work_keys_str_mv | AT cinziabizzoca anewtechniqueforthelaparoscopictreatmentofsimplehepaticcysts AT feliciafiore anewtechniqueforthelaparoscopictreatmentofsimplehepaticcysts AT fabrizioaquilino anewtechniqueforthelaparoscopictreatmentofsimplehepaticcysts AT salvatorefedele anewtechniqueforthelaparoscopictreatmentofsimplehepaticcysts AT mariadisalvo anewtechniqueforthelaparoscopictreatmentofsimplehepaticcysts AT giuseppelucarelli anewtechniqueforthelaparoscopictreatmentofsimplehepaticcysts AT leonardovincenti anewtechniqueforthelaparoscopictreatmentofsimplehepaticcysts AT cinziabizzoca newtechniqueforthelaparoscopictreatmentofsimplehepaticcysts AT feliciafiore newtechniqueforthelaparoscopictreatmentofsimplehepaticcysts AT fabrizioaquilino newtechniqueforthelaparoscopictreatmentofsimplehepaticcysts AT salvatorefedele newtechniqueforthelaparoscopictreatmentofsimplehepaticcysts AT mariadisalvo newtechniqueforthelaparoscopictreatmentofsimplehepaticcysts AT giuseppelucarelli newtechniqueforthelaparoscopictreatmentofsimplehepaticcysts AT leonardovincenti newtechniqueforthelaparoscopictreatmentofsimplehepaticcysts |