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Medline ® Abstract for Reference 42

of 'Diagnosis and management of cystic lesions of the liver'

Laparoscopic resection of benign hepatic cysts: a new standard.
Gamblin TC, Holloway SE, Heckman JT, Geller DA
J Am Coll Surg. 2008;207(5):731.
BACKGROUND: We sought to evaluate the feasibility and outcomes of laparoscopic resection of symptomatic hepatic cysts.
STUDY DESIGN: Fifty-one patients underwent laparoscopic resections for symptomatic hepatic cysts. Resection was accomplished laparoscopically with an Endo-GIA vascular stapler. Data were collected in a prospective database.
RESULTS: Median patient age was 60 years, with a median lesion diameter of 13 cm. Indication for surgical treatment was pain in 92% of patients. Laparoscopic resection was successful in 100% of patients. A pure laparoscopic approach was used in 58% of patients, the remaining used a hand port. Median operating time was 178 minutes. Preoperative diagnosis was polycystic liver in 88% and simple cyst in 12% diagnosed by preoperative imaging. Histologic examination showed 90% to be simple cysts and 10% cystadenomas. There were nine minor perioperative complications. Median hospital stay was 2 days. Relief of symptoms was achieved in all patients operated on for pain, with a median followup of 13 months. Two patients required reoperation for recurrence of the same cyst. CT or MRI was used for yearly followup.
CONCLUSIONS: Laparoscopic resection of symptomatic liver cysts is a feasible and effective method to relieve symptoms with minimal surgical trauma. This series represents the largest report of laparoscopic management for benign hepatic cysts and provides evidence for a routine laparoscopic approach to benign symptomatic cysts. Traditional surgical methods should be reserved for when a malignancy is expected, laparoscopy is contraindicated, or for recurrence after an initial laparoscopic approach.
Department of Surgery, Liver Cancer Center, University of Pittsburgh, Pittsburgh, PA 15213, USA.