LAPAROSCOPIC TREATMENT OF NONPARASITIC CYSTS OF THE LIVER WITH OMENTAL TRANSPOSITION FLAP

Background: Between 1991 and November 1994, 18 patients with large, so litary, nonparasitic liver cysts underwent laparoscopic deroofing; the last 13 of them also received an omental transposition flap in additi on. Methods: Using three to four trocars, the cystic contents were fir st aspirated, and the cyst derooted widely using diathermia. An omenta l transposition flap was fashioned and stapled into the cyst cavity it self. Results: Postoperative complications included one case of pulmon ary atelectasis. Another patient developed a subhepatic bile collectio n which was aspirated percutaneously. On average, patients were discha rged on the 4th (2-14) postoperative day. Follow-up was performed with abdominal ultrasound for 2-43 months (mean 19 months). There were two early cyst recurrences, both in cases without an omental transpositio n flap (overall recurrence rate, 11%; in patients with omental flap, 0 ). Conclusions: Deroofing in combination with an omental transposition flap is a safe and effective therapy for symptomatic solitary liver c ysts and can be performed using minimal-access surgical techniques.