Efficacy of color sonography and harmonic scalpel in laparoscopic management of multiple/lobulated liver cysts and abscesses.
OBJECTIVE
Major concerns of multiple/lobulated liver cysts and abscesses managed by laparoscopic approach are inadequate deroofing/ drainage and hemorrhage. The aim of this study was to test the efficacy of color sonography and ultrasonically activated scalpel employed in this field.


METHODS
Ten patients with multiple/lobulated liver cysts and eight patients with lobulated pyogenic liver abscesses were managed laparoscopically with the aid of laparoscopic color sonography and harmonic scalpel. Clinicopathological data, operative results, complications, and follow-up were retrospectively analyzed.


RESULTS
Ten patients with liver cysts underwent laparoscopic deroofing, in addition to hepatectomy (n=3), cholecystectomy and adrenalectomy (n=l), and Nissen fundoplication (n=1). The number of multiple/lobulated liver cysts deroofed was 5.8 +/- 3.3 (range, 4 to 12). There was no mortality and morbidity in these 10 patients. Eight patients with multilobulated liver abscess underwent laparoscopic drainage, in addition to cholecystectomy (n=3), without conversion. There was no need of blood transfusion perioperatively. The major complications of eight liver abscess cases included residual abscess and prolonged ventilator in one each. Followed-up with a mean time period of 26 +/- 8 months, all patients except one were well without symptomatic recurrence.


CONCLUSIONS
Color sonography and harmonic scalpel made laparoscopic management of multiple/lobulated liver cysts and abscesses more efficacious in terms of precise localization, adequate deroofing/drainage, and better hemostasis.
Yeh
Ta-Sen
TS
Department of Surgery, Chang Gung Memorial Hospital Chang Gung University, Taipei, Taiwan. tsy471027@adm.cgmh.org.tw
Ho
Yu-Pin
YP
Jan
Yi-Yin
YY
Chen
Miin-Fu
MF
D000328:Adult; D000368:Aged; D017081:Cholecystectomy, Laparoscopic; D003560:Cysts / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008100:Liver Abscess / Q000000981:diagnostic imaging* / Q000601:surgery*; D008107:Liver Diseases / Q000000981:diagnostic imaging* / Q000601:surgery*; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013396:Suction; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014464:Ultrasonic Therapy / Q000379:methods*; D018615:Ultrasonography, Doppler, Color