Spontaneously Ruptured Hepatic Cyst Treated by Laparoscopic Deroofing and Cystobiliary Communication Closure 30 Days After the Hepatic Cyst Drainage：A Case Report

Abstract

An 80-year-old man who had visited our gastroenterology department with abdominal distention had undergone hepatic cyst drainage twice, the first 8 months earlier and the second, 1 month earlier. One month after the second cyst drainage, the patient was transported to the emergency room with right upper abdominal pain of sudden onset. Abdominal CT showed a collapsed hepatic cyst and ascites. Drainage of the ascites revealed turbid biliary ascites. We made the diagnosis of cholestatic peritonitis and performed emergency laparoscopic deroofing. After the laparoscopic deroofing, we injected a dye through an endoscopic nasobiliary drainage catheter to identify the cystobiliary communication and performed closure of the cystobiliary communication. The patient was discharged on the 11th postoperative day. At 10 months after the surgery, the hepatic cyst had not increased in size. We report a case of ruptured hepatic cyst 30 days after a hepatic cyst drainage, that was successfully treated by laparoscopic deroofing and cystobiliary communication closure.