A Study of Laparoscopic Fenestration of Liver Cysts in Our Department

Abstract

Purpose: We investigated the factors related to avoiding insertion of a drainage tube and achieving early postoperative discharge during laparoscopic fenestration (LF) of symptomatic liver cysts. Method: This study investigated 44 patients who underwent LF in our department during the last 9 years. The male-to-female ratio was 10:34, which showed that it was more common among females, and the mean age was 65 years. Most of the cysts were present in the right lobe, and the average maximum diameter was 15.9 cm. Results: All 12 patients with polycystic liver disease who underwent LF were Gigot classification type I. Eleven patients underwent preoperative placement of endoscopic nasobiliary drainage (ENBD) tube. Intraoperative bile leakage was found in 5 cases during the procedure; however, there was no bile leakage postoperatively. The mean operation time was 122 minutes. Postoperative ascites retention was only observed in 2 patients at the time of introduction, and all 10 patients who underwent LF with no insertion of intra-peritoneal drainage tube in 2018 were discharged on postoperative day 2. Conclusion: Secure treatments for bile leakage from the cutting edge and luminal surface of the cyst wall during LF of liver cysts enabled us to avoid the perioperative complications and discharge the patients earlier after surgery even without insertion of a drainage tube.