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laparoscopic fenestration vs open fenestration in patients with congenital hepatic cysts: A meta-analysis

World Journal of Gastroenterology 2011年第28期17卷 3359-3365页

作者： Prasoon Pankaj Department of Hepatobiliary Pancreatic Surgery West China HospitalSichuan University

AIM: To determine whether the outcomes of laparoscopic fenestration (LF) were superior to open fenestration (OF) for congenital liver ***: Comparative studies published between January 1991 and May 2010 on Medline (Ovid),Emsco,PubMed,Science Direct;Cochrane Reviews;CNKI;Chinese Biomedical Database,VIP and other electronic databases were *** controlled trials (RCTs) and retrospective case-control studies on the management of congenital hepatic cysts were collected according to the pre-determined eligibility criteria to establish a literature *** was ended in May ***-analysis was performed using RevMan 5.0 software (Cochrane library).RESULTS: Nine retrospective case-control studies involving 657 patients,comparing LF with OF were included for the final pooled *** meta-analysis results showed less operative time [mean difference (MD): -28.76,95% CI: -31.03 to 26.49,P < 0.00001];shorter hospital stay (MD: -3.35,95% CI: -4.46 to -2.24,P < 0.00001);less intraoperative blood loss (MD: -40.18,95% CI: -52.54 to -27.82,P < 0.00001);earlier return to regular diet (MD: -29.19,95% CI: -30.65 to -27.72,P < 0.00001) and activities after operation (MD: -21.85,95% CI: -31.18 to -12.51,P < 0.0001) in LF group;there was no significant difference between the two groups in postoperative complications (odds ratio: 0.99,95% CI: 0.41 to 2.38,P = 0.98) and cysts recurrence ***: The short-term outcomes of LF for patients with congenital hepatic cysts were superior to open approach,but its long-term outcomes should be verified by further RCTs and extended follow-up.

关键词： Congenital hepatic cysts laparoscopic fenestration Open fenestration Systematic review Metaanalysis

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laparoscopic fenestration of multiple giant biliary mucinous cystadenomas of the liver

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World Journal of Gastroenterology 2008年第26期14卷 4257-4259页

作者： A Manours E Lagoudianakis L Alevizos H Markogiannakis G Kafiri C Bramis K Filis K Toutouzas First Department of Propaedeutic Surgery Hippocrateion Hospital University of Athens Athens Medical School Athens 11527 Greece

Biliary cystadenomas of the liver are rare, cystic neoplasms of the biliary ductal system usually occur in middle aged women. We report a case of synchronous multiple huge biliary mucinous cystadenomas with unique features. This is, according to our knowledge, the first report in the literature about three synchronously occurring hepatobiliary cystadenomas. Cystadenomas have a strong tendency to recur, particularly following incomplete excision, and a potential of malignant transformation. A therapeutic re-evaluation may be necessary when the diagnosis of hepatobiliary cystadenoma is made after the operation and an open liver resection should be considered.

关键词： Biliary cystadenoma Liver cysts laparoscopic fenestration

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Long-term results of laparoscopic fenestration for patients with congenital liver cysts

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Hepatobiliary & Pancreatic Diseases International 2007年第6期6卷 600-603页

作者： Bai, Xue-Li Liang, Ting-Bo Yu, Jun Wang, Wei-Lin Shen, Yan Zhang, Min Zheng, Shu-Sen Zhejiang Univ Sch Med Affiliated Hosp 1 Dept Hepatobiliary Pancreat Surg Hangzhou 310003 Peoples R China

BACKGROUND: The feasibility and immediate outcome of laparoscopic fenestration for patients with congenital liver cysts have been generally recognized. The aim of the present study was to assess the long-term results after laparoscopic fenestration. METHODS: A retrospective study was performed on 44 patients with congenital liver cysts who had undergone laparoscopic fenestration between June 1998 and December 2004. Among them, 30 were women and 14 men, aged 57 years on average (range 18-76 years). While 14 patients had solitary cysts, 20 had multiple cysts, and 10 had polycystic liver disease. The results of laparoscopic fenestration, including mortality, morbidity, mean postoperative hospital stay, and recurrences of cysts were evaluated. RESULTS: There was no perioperative death and the morbidity rate was 11% (5/44). All complications were treated conservatively. The mean postoperative hospital stay was 4 days. A mean follow-up of 57 months showed that the rates of cyst recurrence and symptom recurrence were 9% and 4.5%, respectively. CONCLUSION: laparoscopic fenestration as a feasible and safe treatment procedure for patients with congenital liver cysts can yield very good long-term results.

关键词： congenital liver cyst laparoscopic fenestration long-term results follow-up studies

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Factors that influence outcome in non-invasive and invasive treatment in polycystic liver disease patients

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World Journal of Gastroenterology 2008年第20期14卷 3195-3200页

作者： Josué Barahona-Garrido Jesús Camacho-Escobedo Eduardo Cerda-Contreras Jorge Hernández-Calleros Jesús K Yamamoto-Furusho Aldo Torre Misael Uribe Department of Gastroenterology National Institute of Health Sciences and Nutrition "Salvador Zubirán" Mexico City 14000 Mexico

AIM: To evaluate the factors that influence outcome of both non-invasive and invasive treatment of polycystic liver disease. METHODS: Analysis of clinical files of patients with complete follow-up from July 1986 to June 2006. RESULTS: Forty-one patients (male, 7; female, 34), 47.8 ± 11.9 years age, and 5.7 ± 6.7 years follow-up, were studied. Alkaline phosphatase (AP) elevation (15% of patients) was associated with the requirement of invasive treatment (IT, P = 0.005). IT rate was higher in symptomatic than non-symptomatic patients (65.4% vs 14.3%, P = 0.002), and in women taking hormonal replacement therapy (HRT) (P = 0.001). Cysts complications (CC) were more frequent (22%) in the symptomatic patients group (P = 0.023). Patients with body mass index (BMI) > 25 (59%) had a trend to complications after IT (P = 0.075). Abdominal pain was the most common symptom (56%) and indication for IT (78%). Nineteen patients (46%) required a first IT: 12 open fenestration (OF), 4 laparoscopic fenestration (LF) and 3 fenestration with hepatic resection (FHR). Three required a second IT, and one required a third procedure. Complications due to first IT were found in 32% (OF 16.7%, LF 25%, FHR 66.7%), and in thesecond IT in 66.7% (OF 100%). Follow-up mortality rate was 0. CONCLUSION: Presence of symptoms, elevated AP, and CC are associated with IT requirement. HRT is associated with presence of symptoms and IT requirement. Patients with BMI > 25 have a trend be susceptible to IT complications. The proportions of complications are higher in FHR and second IT groups. RS is more frequent after OF.

关键词： Hepatic cysts Open fenestration laparoscopic fenestration Hepatic resection Recurrenceof symptoms Hormonal replacement therapy

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