LAPAROSCOPIC TREATMENT OF NONPARASITIC LIVER CYSTS - ADEQUATE SELECTION OF PATIENTS AND SURGICAL TECHNIQUE

Results of laparoscopic fenestration in patients with a highly symptom atic solitary liver cyst (17 patients) or polycystic liver disease (PL D) (9 patients) were prospectively evaluated in a multicenter practice of general surgeons, Conversion to laparotomy was required in two pat ients because of inaccessible deep liver cyst in one and a diffuse for m of PLD in the other, There was no mortality or major morbidity. Mean postoperative hospital stay was 4.6 days after successful laparoscopi c procedures. During a mean follow-up of 9 months, 23% of the patients had recurrence of symptoms and 38% had radiographic reappearance of c ysts. Factors predicting failure included previous surgical treatment, deep-sited cysts, incomplete deroofing technique, location in the rig ht posterior segments of the liver, and a diffuse form of PLD with sma ll cysts, Adequate selection of patients and type of cystic liver dise ase and meticulous and aggressive surgical technique are recommended.