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Phancharoenkit N, Thienhiran A, Burasakarn P, Fuengfoo P, Hongjinda S. Acute cholangitis caused by a huge hepatic simple cyst: a case report. J Surg Case Rep 2023; 2023:rjad056. [PMID: 36824694 PMCID: PMC9943051 DOI: 10.1093/jscr/rjad056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 01/24/2023] [Indexed: 02/23/2023] Open
Abstract
Simple hepatic cysts are usually asymptomatic and rarely cause complications. Among the rare complications of liver cysts, intracystic hemorrhage is one of the most frequent, and can result in a rapid increase in cyst size. Some simple hepatic cysts may be large and can present with pressure effects, such as abdominal discomfort or obstructive jaundice. A 68-year-old female with a simple huge hepatic cyst was scheduled elective laparoscopic fenestration in 6 weeks. Before the operation, she developed acute cholangitis, resulting from an acute increase in cyst size due to intracystic hemorrhage. Upon open fenestration, 6.1 L of chocolate-like fluid was drained. A huge simple hepatic cyst complicated by intracystic hemorrhage resulted in an acute increase in cyst size. Distortion of the extrahepatic bile duct by the cyst obstructed the bile flow. Acute cholangitis was eventually developed.
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Affiliation(s)
- Nichaphat Phancharoenkit
- Correspondence address. Division of Hepatobiliarypancreas Surgery, Department of Surgery, Phramongkutklao Hospital, Bangkok, Thailand. Tel: +66-88-477-8527; E-mail:
| | - Anuparp Thienhiran
- Division of Hepatobiliarypancreas Surgery, Department of Surgery, Phramongkutklao Hospital, Bangkok, Thailand
| | - Pipit Burasakarn
- Division of Hepatobiliarypancreas Surgery, Department of Surgery, Phramongkutklao Hospital, Bangkok, Thailand
| | - Pusit Fuengfoo
- Division of Hepatobiliarypancreas Surgery, Department of Surgery, Phramongkutklao Hospital, Bangkok, Thailand
| | - Sermsak Hongjinda
- Division of Hepatobiliarypancreas Surgery, Department of Surgery, Phramongkutklao Hospital, Bangkok, Thailand
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Sato K, Ota K, Maki J, Sato S, Masuda H, Tanaka M. Laparoscopic fenestration of a large peritoneal inclusion cyst: Description of a new surgical technique. Eur J Obstet Gynecol Reprod Biol 2017; 219:68-69. [PMID: 29055220 DOI: 10.1016/j.ejogrb.2017.10.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 10/12/2017] [Accepted: 10/15/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Kenji Sato
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Japan.
| | - Kuniaki Ota
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Japan
| | - Junko Maki
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Japan
| | - Suguru Sato
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Japan
| | - Hirotaka Masuda
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Japan
| | - Mamoru Tanaka
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Japan
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Yao DB, Wu SD. Application of stapling devices in liver surgery: Current status and future prospects. World J Gastroenterol 2016; 22:7091-7098. [PMID: 27610019 PMCID: PMC4988303 DOI: 10.3748/wjg.v22.i31.7091] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 06/07/2016] [Accepted: 06/15/2016] [Indexed: 02/06/2023] Open
Abstract
The liver is a vascular-rich solid organ. Safe and effective dissection of the vessels and liver parenchyma, and control of intraoperative bleeding are the main concerns when performing liver resection. Several studies have confirmed that intraoperative blood loss and postoperative transfusion are predictors of postoperative morbidity and mortality in liver surgery. Various methods and instruments have been developed during hepatectomy. Stapling devices are crucial for safe and rapid anastomosis. They are used to divide hepatic veins and portal branches, and to transect liver parenchyma in open liver resection. In recent years, laparoscopic liver surgery has developed rapidly, and is now preferred by many surgeons. Stapling devices have also been gradually introduced in laparoscopic liver surgery, from dividing vascular and biliary structures to parenchymal transection. This may be because staplers make manipulation more simple, rapid and safe. Even in single incision laparoscopic surgery, which is recognized as a new minimally invasive technique, staplers are also utilized, especially in left lateral hepatectomy. For safe application of stapling devices in liver surgery, more related designs and modifications, such as application of a suitable laparoscopic articulating liver tissue crushing device, a staple line reinforcement technique with the absorbable polymer membrane or radiofrequency ablation assistance, are still needed. More randomized studies are needed to demonstrate the benefits and find broader indications for the use of stapling devices, to help expand their application in liver surgery.
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Karabicak I, Karabulut K. Single port laparoscopic liver surgery: A minireview. World J Gastrointest Endosc 2016; 8:444-50. [PMID: 27358670 PMCID: PMC4919693 DOI: 10.4253/wjge.v8.i12.444] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 04/20/2016] [Accepted: 05/17/2016] [Indexed: 02/05/2023] Open
Abstract
Nowadays, the trend is to perform surgeries with "scarless" incisions. In light of this, the single-port laparoscopic surgery (SPLS) technique is rapidly becoming widespread due to its lack of invasiveness and its cosmetic advantages, as the only entry point is usually hidden in the umbilicus. The interest in "scarless" liver resections did not grow as rapidly as the interest in other scarless surgeries. Hepatopancreatobiliary surgeons are reluctant to operate a malignant lesion through a narrow incision with limited exposure. There are concerns over adverse oncological outcomes for single-port laparoscopic liver resections (SPL-LR) for hepatocellular carcinoma or metastatic colorectal cancer. In addition, getting familiar with using the operating instruments through a narrow incision with limited exposure is very challenging. In this article, we reviewed the published literature to describe history, indications, contraindications, ideal patients for new beginners, technical difficulty, advantages, disadvantages, oncological concern and the future of SPL-LR.
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Tanaka M, Inoue Y, Mise Y, Ishizawa T, Arita J, Takahashi Y, Saiura A. Laparoscopic deroofing for polycystic liver disease using laparoscopic fusion indocyanine green fluorescence imaging. Surg Endosc 2015; 30:2620-3. [PMID: 26416378 DOI: 10.1007/s00464-015-4526-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2015] [Accepted: 08/13/2015] [Indexed: 01/17/2023]
Abstract
BACKGROUND Laparoscopic deroofing is widely used for the treatment of symptomatic polycystic liver disease (PCLD). However, bile leakage is a common complication of surgical management for PCLD. Until now, indocyanine green fluorescence imaging (IGFI) has played an active role in hepatobiliary surgery. Herein, we report the effective application of a laparoscopic fusion IGFI system, known as PINPOINT, for laparoscopic deroofing. METHODS In this study, we performed laparoscopic deroofing for PCLD using the laparoscopic fusion IGFI system. We conducted the procedure mainly under the normal view mode, occasionally switching to the fusion IGFI mode. First, we confirmed that the liver cysts did not contain bile using the fusion IGFI mode and then used a percutaneous puncture needle to remove the fluid from some of the giant cysts. Second, using the fusion IGFI mode, we were able to detect thin biliary branches and to adjust the division line of the cyst wall accordingly or, occasionally, to ligate the branches. Finally, we searched for and identified unexpected small bile leakage and then closed it using sutures. RESULTS The laparoscopic fusion IGFI system can simultaneously show fluorescent images, such as cholangiography and the liver parenchyma, on the normal color view. In the fusion IGFI mode, the intrahepatic bile duct and liver parenchyma can be easily discriminated in real time throughout the procedure. Accordingly, the laparoscopic fusion IGFI system is useful for the surgical treatment of PCLD, in which the boundary between the liver cysts and the liver parenchyma can otherwise be difficult to identify. This technique also enables the branches of Glisson's capsule to be identified without any other intervention. CONCLUSION The novel application of the laparoscopic fusion IGFI system allows reliable navigation for PCLD surgery.
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Affiliation(s)
- Masayuki Tanaka
- Department of HBP Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Yosuke Inoue
- Department of HBP Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Yoshihiro Mise
- Department of HBP Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Takeaki Ishizawa
- Department of HBP Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Junichi Arita
- Department of HBP Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Yu Takahashi
- Department of HBP Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Akio Saiura
- Department of HBP Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
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Mehtsun WT, Patel MS, Markmann JF, Hertl M, Vagefi PA. Obstructive jaundice caused by a giant non-parasitic hepatic cyst. Ann Hepatol 2015. [PMID: 25671837 DOI: 10.1016/s1665-2681(19)30790-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Winta T Mehtsun
- Division of Transplantation Surgery, Massachusetts General Hospital. Harvard Medical School, Boston, MA. U.S.A
| | - Madhukar S Patel
- Division of Transplantation Surgery, Massachusetts General Hospital. Harvard Medical School, Boston, MA. U.S.A
| | - James F Markmann
- Division of Transplantation Surgery, Massachusetts General Hospital. Harvard Medical School, Boston, MA. U.S.A
| | - Martin Hertl
- Division of Transplantation Surgery, Massachusetts General Hospital. Harvard Medical School, Boston, MA. U.S.A
| | - Parsia A Vagefi
- Division of Transplantation Surgery, Massachusetts General Hospital. Harvard Medical School, Boston, MA. U.S.A
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