title: Technical challenges in treating recurrent non-parasitic hepatic cysts.
abstract: OBJECTIVE
  Simple non-parasitic hepatic cysts (NPHC) are relatively frequent and often asymptomatic. When symptomatic, surgery is recommended. Most patients can be treated with laparoscopic deroofing. However, recurrence rate varies greatly, and there is no consensus on the optimal approach for symptomatic recurrences.
  
  
  METHODS
  A retrospective study on 33 patients surgically treated for symptomatic simple NPHC was performed. Recurrence was considered only when symptomatic.
  
  
  RESULTS
  Most patients were initially submitted to laparoscopic deroofing. Symptomatic recurrence was found in five patients treated with laparoscopic deroofing. Specific location of the cysts was a common characteristic. In three cases, recurrence was unsuccessfully treated with open deroofing, and patients were submitted to resection. Open deroofing does not offer any advantage in terms of recurrence in comparison with laparoscopic deroofing.
  
  
  CONCLUSIONS
  Laparoscopic deroofing can be proposed for symptomatic recurrent cysts, except for cysts located in S4, S7 and S8, where recurrence rates are higher and complete resection should be undertaken.
authors.affiliation: Division of Digestive Surgery, Hôpitaux Privés de Metz, Metz, France.
authors.forename: Tarek
authors.initials: T
authors.lastname: Debs
authors.affiliation: Division of General Surgery, CHU Hospital, Jean Monnet University, Saint Etienne, France. Electronic address: Radwankassir42@hotmail.Fr.
authors.forename: Radwan
authors.initials: R
authors.lastname: Kassir
authors.affiliation: Division of Digestive Surgery, Hôpitaux Privés de Metz, Metz, France.
authors.forename: Isabella
authors.initials: I
authors.lastname: Reccia
authors.affiliation: Division of Digestive Surgery, Hôpitaux Privés de Metz, Metz, France.
authors.forename: Bachir
authors.initials: B
authors.lastname: Elias
authors.affiliation: Division of Digestive Surgery and Liver Transplantation, Hôpital Archet 2, Nice, France.
authors.forename: Imed
authors.initials: I
authors.lastname: Ben Amor
authors.affiliation: Division of Digestive Surgery and Liver Transplantation, Hôpital Archet 2, Nice, France.
authors.forename: Antonio
authors.initials: A
authors.lastname: Iannelli
authors.affiliation: Division of Digestive Surgery and Liver Transplantation, Hôpital Archet 2, Nice, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Gugenheim
authors.affiliation: Division of Digestive Surgery, Hôpitaux Privés de Metz, Metz, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Johann
mesh_terms: D000328:Adult; D000368:Aged; D003560:Cysts / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008107:Liver Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Laparoscopic deroofing; Non-parasitic hepatic cyst; Recurrence; Simple hepatic cyst