Articles Tập 67 Số CĐ13-HNKH Bệnh viện 19-8 10/09/2026

LAPAROSCOPIC SURGERY TO TREAT TWO LARGE HEPATIC CYSTS IN TWO LIVER LOBES.

Dũng Nguyễn Thanh, Bảo Trương Quang, Thịnh Vo Dinh
DOI: 10.52163/yhc.v67iCD13.6396
0 Views
0 Downloads
Keywords
Liver cyst, simple liver cyst, laparoscopic deroofing of liver cyst
Abstract

Background: Large liver cysts causing compression or rupture require surgical intervention, with laparoscopic wide deroofing being the current standard method.

Case report: A 52-year-old female was admitted with a 2-day history of epigastric pain, without fever or jaundice, and a 3-year history of monitored liver cysts. MRI revealed two large cysts (segment IV 10 cm; segment VIII 12 cm, both with thin walls and no septations) and three small cysts. Serological tests for parasites and tumor markers were within normal limits.

Intervention and clinical course: The patient underwent laparoscopic deroofing of both liver cysts. Intraoperative findings showed a ruptured segment IV cyst and a tense segment VIII cyst. Laparoscopic wide deroofing was performed using an ultrasonic scalpel, combined with omentopexy into the right cyst cavity to obliterate dead space and optimize secretion drainage. The operative time was 50 minutes with no blood loss. The postoperative course was stable, with discharge on day 5 and benign histopathology. Follow-up at 1, 3, and 6 months showed no fluid recurrence on ultrasound.

Conclusion: Laparoscopic deroofing using an ultrasonic scalpel combined with omentopexy is a safe and effective method for large liver cysts complicated by rupture, helping to obliterate dead space and minimize postoperative fluid collection.

References
[1]
1. European Association for the Study of the Liver (2022). EASL Clinical Practice Guidelines on the management of cystic liver diseases. Journal of Hepatology, 77(4), 1083–1108. https://doi.org/10.1016/j.jhep.2022.06.002 Google Scholar
[2]
2. Lin, T. Y., Chen, C. C., & Wang, S. M. (1968). Treatment of non-parasitic cystic disease of the liver: a new approach to therapy with polycystic liver. Annals of Surgery, 168(5), 921–927. Google Scholar
[3]
3. Gomez, A., et al. (2021). Contemporary Management of Hepatic Cyst Disease: Techniques and Outcomes at a Tertiary Hepatobiliary Center. Journal of Gastrointestinal Surgery, 25(1), 77–84. https://doi.org/10.1007/s11605-019-04473-5 Google Scholar
[4]
4. Kersik, A., et al. (2023). Laparoscopic deroofing of simple liver cysts: do ancillary techniques, surgical devices, and indocyanine green improve outcomes? European Surgery, 55(3), 100–106. https://doi.org/10.1007/s10353-023-00799-w Google Scholar
[5]
5. Shimizu, T., et al. (2022). Management of Simple Hepatic Cyst. Journal of Nippon Medical School, 89(1), 2–8. https://doi.org/10.1272/jnms.JNMS.2022_89-106 Google Scholar
[6]
6. Zurli, L., et al. (2021). Atypic large hepatic cyst with persistent elevated CA19.9 serum value: utility of intracystic CA72.4 dosage for a mini-invasive management. Clinical Journal of Gastroenterology, 14(1), 258–262. https://doi.org/10.1007/s12328-020-01311-6 Google Scholar
[7]
7. Ikeda, T., et al. (2024). Laparoscopic deroofing for a giant hepatic cyst with biliary communication: a case report. Journal of Surgical Case Reports, 2024(3), rjae176. https://doi.org/10.1093/jscr/rjae176 Google Scholar
[8]
8. Mizukami, R., et al. (2024). Ruptured large hepatic cyst with elevated serum and ascites CA19-9 level. Journal of Surgical Case Reports, 2024(8), rjae309. https://doi.org/10.1093/jscr/rjae309 Google Scholar
[9]
9. Emmermann, A., et al. (1997). Laparoscopic treatment of nonparasitic cysts of the liver with omental transposition flap. Surgical Endoscopy, 11(7), 734–736. https://doi.org/10.1007/s004649900443 Google Scholar
[10]
10. Macedo, F. I. (2013). Current management of noninfectious hepatic cystic lesions: A review of the literature. World Journal of Hepatology, 5(9), 462–469. https://doi.org/10.4254/wjh.v5.i9.462 Google Scholar