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Titolo:
Large cystic lesions of the liver in adults: A 15-year experience in a tertiary center
Autore:
Regev, A; Reddy, KR; Berho, M; Sleeman, D; Levi, JU; Livingstone, AS; Levi, D; Ali, U; Molina, EG; Schiff, ER;
Indirizzi:
Univ Miami, Sch Med, Ctr Liver Dis, Div Hepatol,Dept Internal Med, Miami, FL 33136 USA Univ Miami Miami FL USA 33136 atol,Dept Internal Med, Miami, FL 33136 USA Univ Miami, Sch Med, Ctr Liver Dis, Div Hepatol,Dept Surg, Miami, FL 33136USA Univ Miami Miami FL USA 33136 , Div Hepatol,Dept Surg, Miami, FL 33136USA Univ Miami, Sch Med, Ctr Liver Dis, Div Hepatol,Dept Pathol, Miami, FL 33136 USA Univ Miami Miami FL USA 33136 iv Hepatol,Dept Pathol, Miami, FL 33136 USA
Titolo Testata:
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS
fascicolo: 1, volume: 193, anno: 2001,
pagine: 36 - 45
SICI:
1072-7515(200107)193:1<36:LCLOTL>2.0.ZU;2-2
Fonte:
ISI
Lingua:
ENG
Soggetto:
HYDATID-DISEASE; HEPATOBILIARY CYSTADENOMA; LAPAROSCOPIC FENESTRATION; ALCOHOL SCLEROTHERAPY; SURGICAL-MANAGEMENT; NONPARASITIC CYSTS; HEPATIC CYSTS; DIAGNOSIS; ECHINOCOCCOSIS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
39
Recensione:
Indirizzi per estratti:
Indirizzo: Regev, A Univ Miami, Sch Med, Ctr Liver Dis, Div Hepatol,Dept Internal Med, 1500 NW12 Ave,Suite 1101, Miami, FL 33136 USA Univ Miami 1500 NW 12 Ave,Suite 1101 Miami FL USA 33136 33136 USA
Citazione:
A. Regev et al., "Large cystic lesions of the liver in adults: A 15-year experience in a tertiary center", J AM COLL S, 193(1), 2001, pp. 36-45

Abstract

BACKGROUND: Cystic lesions of the liver consist of a heterogeneous group of disorders and may present a diagnostic and therapeutic challenge. Large hepatic cysts tend to be symptomatic and can cause complications more often than smaller ones. STUDY DESIGN: We performed a retrospective review of adults diagnosed withlarge (greater than or equal to 4cm) hepatic cystic lesions at our center,over a period of 15 years. Polycystic disease and abscesses were not included. RESULTS: Seventy-eight patients were identified. In 57 the lesions were simple cysts, in 8 echinococcal cysts, in 8 hepatobiliary cystadenomas, and in 1 hepatobiliary cystadenocarcinoma. In four patients, the precise diagnosis could not be ascertained. Mean size was 12.1 cm (range, 4 to 30 cm). Most simple cysts were found in women (F:M, 49:8). Bleeding into a cyst (two patients) and infection (one patient) were rare manifestations. Percutaneousaspiration of 28 simple cysts resulted in recurrence in 100% of the cases within 3 weeks to 3 months (mean 4 1/2 months). Forty-eight patients were treated surgically by wide unroofing or resection (laparoscopically in 18), which resulted in low recurrence rates (11% for laparoscopy and 13% for open unroofing). Four of the eight patients with echinococcal cysts were symptomatic. All were treated by open resection after irrigation of the cavity with hypertonic saline. There was no recurrence during a followup period of 2 to 14 years. Hepatobiliary cystadenomas occurred more commonly in women (F:M, 7:1) and in the left hepatic lobe (left:right, 8:0). Seven were multiloculated. All were treated by open resection, with no recurrence, and none had malignant changes. Cystadenocarcinoma was diagnosed in a 77-year-old man, and was treated by left hepatic lobectomy. CONCLUSIONS: Large symptomatic simple cysts invariably recur after percutaneous aspiration. Laparoscopic unroofing can be successfully undertaken, with a low recurrence rare. Open resection after irrigation with hypertonic saline is a safe and effective treatment for echinococcal cysts. Hepatobiliary cystadenomas have predilection for women and for the left hepatic lobe. Malignant transformation is an uncommon but real risk. Open resection is a safe and effective treatment for hepatobiliary cystadenoma, and is associated with a low recurrence race. (J Am Coll Surg 2001;193:36-45. (C) 2001 by the American College of Surgeons).

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 09/04/20 alle ore 20:11:54