Document Detail


The management of simple hepatic cysts: sclerotherapy or laparoscopic fenestration.
MedLine Citation:
PMID:  11777137     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Prior to the era of laparoscopic surgery, open surgical deroofing was considered to be the most appropriate therapy for uncomplicated simple hepatic cysts. Recently, there have been a number of reports of successful laparoscopic fenestration of simple hepatic cysts. Simple aspiration of these cysts is associated with a high recurrence rate. Cyst sclerosis with alcohol and, more recently, minocycline hydrochloride have been found to be effective in their management. So far there have been no trials comparing laparoscopic deroofing with sclerotherapy. A lack of consensus in their management results in considerable confusion and difficulty in deciding the optimum form of therapy. METHODS: A systematic review of articles on the subject appearing in journals in the English language was conducted using the Medline database and by cross-referencing. RESULTS AND CONCLUSIONS: Both laparoscopic deroofing and cyst sclerosis have been found to be effective in partial or complete obliteration of the cyst and in the relief of symptoms produced by the cyst. It is essential to rule out cystadenoma, malignancy, biliary communication and infection prior to treating these cysts. Alcohol/minocycline based sclerotherapy has the advantage of being associated with a lower incidence of complications. Surgery is indicated if it is difficult to rule out the above mentioned conditions, in the presence of biliary communication, in those cysts where sclerosis has been ineffective and in cases of recurrence. The choice between open and laparoscopic surgery depends on the location of the cysts within the liver parenchyma.
Authors:
K Moorthy; N Mihssin; P W Houghton
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Publication Detail:
Type:  Comparative Study; Journal Article; Review    
Journal Detail:
Title:  Annals of the Royal College of Surgeons of England     Volume:  83     ISSN:  0035-8843     ISO Abbreviation:  Ann R Coll Surg Engl     Publication Date:  2001 Nov 
Date Detail:
Created Date:  2002-01-04     Completed Date:  2002-01-14     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  7506860     Medline TA:  Ann R Coll Surg Engl     Country:  England    
Other Details:
Languages:  eng     Pagination:  409-14     Citation Subset:  IM    
Affiliation:
Department of Surgery, Torbay General Hospital, Torquay, UK. moorthyk@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Cysts / diagnosis,  therapy*
Drainage
Ethanol / therapeutic use
Humans
Laparoscopy / methods*
Liver Diseases / diagnosis,  therapy*
Minocycline / therapeutic use
Sclerosing Solutions / therapeutic use
Sclerotherapy / methods*
Chemical
Reg. No./Substance:
0/Sclerosing Solutions; 10118-90-8/Minocycline; 64-17-5/Ethanol
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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