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Titolo:
The surgical management of congenital liver cysts - The need for a tailored approach with appropriate patient selection and proper surgical technique
Autore:
Gigot, JF; Metairie, S; Etienne, J; Horsmans, Y; van Beers, BE; Sempoux, C; Deprez, P; Materne, R; Geubel, A; Glineur, D; Gianello, P;
Indirizzi:
Univ Catholique Louvain, St Luc Univ Hosp, Dept Digest Surg, B-1200 Brussels, Belgium Univ Catholique Louvain Brussels Belgium B-1200 B-1200 Brussels, Belgium Univ Catholique Louvain, St Luc Univ Hosp, Dept Gastroenterol, B-1200 Brussels, Belgium Univ Catholique Louvain Brussels Belgium B-1200 B-1200 Brussels, Belgium Univ Catholique Louvain, St Luc Univ Hosp, Dept Med Imaging, B-1200 Brussels, Belgium Univ Catholique Louvain Brussels Belgium B-1200 B-1200 Brussels, Belgium Univ Catholique Louvain, St Luc Univ Hosp, Dept Pathol, B-1200 Brussels, Belgium Univ Catholique Louvain Brussels Belgium B-1200 B-1200 Brussels, Belgium
Titolo Testata:
SURGICAL ENDOSCOPY-ULTRASOUND AND INTERVENTIONAL TECHNIQUES
fascicolo: 4, volume: 15, anno: 2001,
pagine: 357 - 363
SICI:
0930-2794(200104)15:4<357:TSMOCL>2.0.ZU;2-P
Fonte:
ISI
Lingua:
ENG
Soggetto:
SOLITARY HEPATIC CYSTS; SYMPTOMATIC NONPARASITIC CYSTS; LAPAROSCOPIC MANAGEMENT; PERCUTANEOUS DRAINAGE; MESENCHYMAL STROMA; LESIONS; FENESTRATION; CYSTADENOMA; DIAGNOSIS; DISEASE;
Keywords:
congenital liver cyst; laparoscopy; fenestration; liver;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
39
Recensione:
Indirizzi per estratti:
Indirizzo: Gigot, JF Univ Catholique Louvain, St Luc Univ Hosp, Dept Digest Surg, Hippocrate Ave 10, B-1200 Brussels, Belgium Univ Catholique Louvain HippocrateAve 10 Brussels Belgium B-1200
Citazione:
J.F. Gigot et al., "The surgical management of congenital liver cysts - The need for a tailored approach with appropriate patient selection and proper surgical technique", SURG ENDOSC, 15(4), 2001, pp. 357-363

Abstract

Background: Most series that report the results of surgical treatment for congenital liver cysts focus more on the technical aspects of the operationthan on the late outcome of these patients. In this paper, we emphasize the importance of appropriate patient selection and adequate surgical technique for successful long-term outcome. Methods: Twenty-four consecutive patients with congenital liver cysts wereselected for surgical treatment. According to our own classification, 13 patients had simple liver cysts, nine had multicystic liver disease, and twohad type I polycystic liver disease. All of these patients were treated bythe fenestration technique. An open approach was used for five patients (group I) treated between 1984 and 1990. In 19 patients (group 2) treated since 1991, a laparoscopic approach was used. The incidence of complicated liver cysts was 40% in group 1 and 68% in group 2. Results: There were no treatment-related deaths in this series. The mean postoperative hospital stay was significantly shorter for patients who underwent successful laparoscopic fenestration (p < 0.05). In the open group (roup I), there were no postoperative complications, and all patients were alive and fi ee of symptoms during a mean follow-up of 130 months, without anysign of cyst recurrence, In the laparoscopic group (group 2), four patients were converted to open surgery. One of these patients had an inaccessibleposterior cyst; another had bile within the cystic cavity, h further two cases had complicated liver cysts with an uncertain diagnosis between congenital and neoplastic cysts. Four patients (21%) developed peri- or postoperative complications. During a mean follow-up time of 38.5 months, none of the patients with simple liver cysts incurred late symptoms or signs of cyst recurrence. In the six patients with multicystic liver disease, one developed disease-related cyst progression (17%) and required reoperation. One of the two patients with type I polycystic liver disease (50%) developed asymptomatic disease-related cyst progression. Conclusions: When patients are carefully selected and a proper surgical technique is employed, excellent long-term results with a low morbidity rate can be achieved in patients with congenital liver cysts. Patients with multicystic liver disease or type I polycystic liver disease are more prone to late cyst recurrence. A tailored approach is thus indicated for patients with congenital liver cystic disease. However, the laparoscopic approach appears to be the gold standard for the treatment of highly symptomatic or complicated simple liver cysts.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 14/07/20 alle ore 12:43:41