title: Management of giant hepatic cysts in the laparoscopic era.
abstract: OBJECTIVE
  We sought to evaluate the feasibility and outcomes of laparoscopic resection of giant hepatic cysts and surgical success, focusing on cyst recurrence.
  
  
  METHODS
  From February 2004 to August 2011, 37 consecutive patients with symptomatic hepatic cysts were evaluated and treated at Dong-A University Hospital. Indications were simple cysts (n = 20), multiple cysts (n = 6), polycystic disease (n = 2), and cystadenoma (n = 9).
  
  
  RESULTS
  The median patient age was 64 years, with a mean lesion diameter of 11.4 cm. The coincidence between preoperative imaging and final pathologic diagnosis was 54% and half (n = 19) of the cysts were located in segments VII and VIII. Twenty-two patients had American Society of Anesthesiologists (ASA) classification I and II, and nine had ASA classification III. Surgical treatment of hepatic cysts were open liver resection (n = 3), laparoscopic deroofing (n = 24), laparoscopic cyst excision (n = 4), laparoscopic left lateral sectionectomy (n = 2), hand assisted laparoscopic procedure (n = 2), and single port laparoscopic deroofing (n = 2). The mean fellow-up was 21 months, and six patients (16%) experienced radiographic-apparent recurrence. Reoperation due to recurrence was performed in two patients. Among the factors predicting recurrence, multivariate analysis revealed that interventional radiological procedures and pathologic diagnosis were statistically significant.
  
  
  CONCLUSIONS
  Laparoscopic resection of giant hepatic cysts is a simple and effective method to relieve symptoms with minimal surgical trauma. Moreover, the recurrence is dependent on the type of pathology involved, and the sclerotherapy undertaken.
authors.affiliation: Department of Surgery, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Chan Joong
authors.initials: CJ
authors.lastname: Choi
authors.forename: Young Hoon
authors.initials: YH
authors.lastname: Kim
authors.forename: Young Hoon
authors.initials: YH
authors.lastname: Roh
authors.forename: Ghap Joong
authors.initials: GJ
authors.lastname: Jung
authors.forename: Jeong Wook
authors.initials: JW
authors.lastname: Seo
authors.forename: Yang Hyun
authors.initials: YH
authors.lastname: Baek
authors.forename: Sung Wook
authors.initials: SW
authors.lastname: Lee
authors.forename: Myung Hwan
authors.initials: MH
authors.lastname: Roh
authors.forename: San Young
authors.initials: SY
authors.lastname: Han
authors.forename: Jin Sook
authors.initials: JS
authors.lastname: Jeong
keywords: Hepatic cyst; Laparoscopy; Liver
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