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• W4313132524 abstract "Background: The standard of care for symptomatic hepatic cyst management is cyst fenestrations, aspirations, and de-bulking procedures. These procedures are effective at immediate symptom improvement but are susceptible to recurrence. There is limited data surrounding the recurrence rate after a partial hepatectomy as a means of cyst removal. We report our experience using the maximal diameter of the cyst to guide complete resection. Methods: This study is a retrospective analysis of patients undergoing surgical management for hepatic cysts between the years of 2008 and 2016. There were 76 cyst resections performed by the senior author. For both simple cyst and polycystic liver disease (PCLD) cyst resections, the standard of care was a laparoscopic approach with the maximal diameter concept (MDC) of the cyst used to guide resection. The cases were followed with imaging and symptomatology to determine recurrence. Results: Of resections included in the study, 73 were done utilizing the maximal diameter concept (MDC) and 3 were simple cyst fenestrations. 66 patients were female, with a median age of 62 (range 56-71). Simple cysts (n=49) and PCLD (n=27) were the two etiologies. Of the 49 simple liver cyst cases, 47 of them were MDC resections and two were cyst fenestrations. 54 cases (71%) were done laparoscopically. Three patients (6%) had previous liver cyst fenestrations. Average operating time was 105min (±46), average length of stay (LOS) was 2 days (±1.7), and average diameter of the removed specimen was 13.0cm (±14). One patient (2%) in this group developed a recurrence of symptomatic liver at an average of 4.4 years after the operation. Of the 27 PCLD cases, 26 of them were complete resections and one was a cyst fenestration. 13 cases were done laparoscopically. Five patients (29.63%) had previous liver cyst fenestrations. Average operating time was 156min (±74), average length of hospital stay was 4 days (±3), and average diameter of the removed specimen was 9.7cm (±6). Five patients (18.52%) required blood transfusions during surgery. Three patients (11.11%) in this group developed a recurrence of symptomatic liver cysts at an average of 4.6 years after the operation. Conclusion: Patients undergoing surgical management of liver cysts using the MDC had favorable outcomes and an exceedingly small chance of recurrence. This contrasts with data in literature where up to a 10% risk of recurrence has been noted.View Large Image Figure ViewerDownload Hi-res image Download (PPT)" @default.
• W4313132524 created "2023-01-06" @default.
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• W4313132524 date "2022-01-01" @default.
• W4313132524 modified "2023-09-27" @default.
• W4313132524 title "Role of Surgical Resection in Management of Hepatic Cysts: Results from a Standardized Approach" @default.
• W4313132524 doi "https://doi.org/10.1016/j.hpb.2022.05.396" @default.
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