Laparoscopic fenestration of liver cysts in polycystic liver disease results in a median volume reduction of 12.5%.
BACKGROUND
Patients with polycystic liver disease (PCLD) may develop symptoms due to increased liver volume. Laparoscopic fenestration is one of the options to reduce liver volume and to relieve symptoms. This study was performed to evaluate the safety and efficacy of laparoscopic liver cyst fenestration.


METHODS
Twelve patients (all female, median age 45 years, range 35-58) with symptomatic PCLD were included between August 2005 and April 2007. Surgical data were recorded, liver volumes were measured on pre- and postoperative computed tomography (CT) scans, and patients completed a validated symptom-based questionnaire pre- and postoperatively.


RESULTS
Median preoperative liver volume was 4,854 ml (range 1,606-8,201) and decreased to 4,153 ml postoperatively (range 1,556-8,232) resulting in median liver volume reduction of 12.5% (range +9.5 to -24.7%). Median procedural time was 123.5 min (range 50-318), and median hospitalization period was 3.5 days (range 1-8). Postoperative complications occurred in three patients including biliary leakage, obstruction of inferior vena cava and sepsis, all recovering with conservative management. Patients reported decreased symptoms of postprandial fullness and abdominal distension.


CONCLUSIONS
Laparoscopic fenestration in PCLD patients results in volume reduction of 12.5% and decrease of symptoms.
van Keimpema
Loes
L
Department of Medicine, Division of Gastroenterology and Hepatology, University Medical Center St. Radboud, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. L.vanKeimpema@mdl.umcn.nl
Ruurda
Jelle P
JP
Ernst
Miranda F
MF
van Geffen
Hendrikus J A A
HJ
Drenth
Joost P H
JP
D000328:Adult; D003560:Cysts / Q000000981:diagnostic imaging / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000379:methods; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008099:Liver / Q000473:pathology* / Q000601:surgery; D008107:Liver Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D009929:Organ Size; D019518:Postprandial Period; D014057:Tomography, X-Ray Computed