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A Journal on Surgery

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Chirurgia 2003 February;16(1):15-8

language: Italian

Indications for and limitations of laparoscopic finestration in the surgical management of solitary liver cysts

Petrocelli P., Corsale I., Colugnat D., Cerone M., Matocci G.


There is no unanimous opinion regarding treatment indications and modalities for solitary, non-parasitic liver cysts. Those below 5 cm, symptomatic and non-complicated, can be treated by aspiration and echo- or Tc-guided percutaneous sclerosis. Surgical therapy is necessary in symptomatic or complicated cysts bigger than 5 cm, in case of doubtful diagnosis with respect to neoplastic pathologies and in tumescences that present a tendency to progressively increase in dimensions. Also to be considered for surgical indication are asymptomatic cysts smaller than 5 cm with central localisation, owing to the frequent occurrence of hilar compression, and all those bigger than 120 cm owing to the high risk of complications. The most commonly adopted operation is Lin's fenestration. This operation can easily be carried out with laparoscopy, reducing operating times below 60 minutes and hospitalisation to 72 hours with results comparable to open techniques. The risk of postoperative sepsis or ascitis is greatly reduced. Laparotomic conversion is necessary in 7% of patients. Recurrence in trated cysts is possible in 11% of cases, higher if it is a case of fenestrated multiple cysts and of diameter superior to 5 cm or cysts in which partial resection of the dome is carried out.

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