Role of laparoscopy in hepatic cyst surgery.
BACKGROUND
Hepatic cysts are detected incidentally in 2.5-5% of the population. Only about 15% of such cysts are symptomatic. Since laparoscopic deroofing for liver cysts was first described in 1991 there have been a number of reports of successful laparoscopic management of hepatic cysts, including the laparoscopic management of complex and parasitic cysts.


METHODS
A systematic review of English-language articles on the subject appearing in journals through May 2002 was conducted using the Medline database.


RESULTS
Only a minority of cystic liver lesions need treatment, and the therapeutic approach is guided by the type of cyst. Laparoscopic deroofing (combined with omentoplasty and/or oversewing) of uncomplicated liver cysts is associated with a recurrence rate of 10-25%, with less morbidity and mortality as compared to open surgery. On the other hand, treatment of complex liver cysts and hydatid cysts by laparoscopy is not considered a standard approach.


CONCLUSIONS
The laparoscopic approach in uncomplicated but symptomatic liver cysts is effective, with low morbidity and mortality. Additional omentoplasty or oversewing appears to reduce the recurrence rate.
Gloor
B
B
Department of Visceral and Transplantation Surgery, University of Bern, Inselspital, CH-3010 Bern, Switzerland.
Ly
Q
Q
Candinas
D
D
D003560:Cysts / Q000601:surgery*; D004444:Echinococcosis, Hepatic / Q000601:surgery; D006801:Humans; D010535:Laparoscopy; D008107:Liver Diseases / Q000601:surgery*; D009852:Omentum / Q000601:surgery; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed