Laparoscopic fenestration in polycystic liver disease

Area of Science:

• Hepatobiliary Surgery
• Minimally Invasive Procedures
• Gastroenterology

Background:

• Adult polycystic liver disease (APLD) can cause significant symptoms.
• Previous treatments for APLD include percutaneous sclerotherapy and open surgery.

Purpose of the Study:

• To evaluate the efficacy and safety of laparoscopic cyst fenestration for symptomatic APLD.
• To assess the potential for repeat laparoscopic procedures in APLD management.

Main Methods:

• Sixteen laparoscopic cyst fenestrations were performed in 13 women with symptomatic APLD.
• Four patients had prior treatment attempts (percutaneous sclerotherapy or open fenestration).
• Median of 32 cysts were deroofed in primary procedures.

Main Results:

• No in-hospital deaths occurred; six patients experienced transient ascites.
• Eleven patients had immediate symptom relief, but eight developed recurrent symptoms within a median of 26 months.
• Repeat laparoscopic fenestrations were performed without complications, with rare perihepatic adhesions.

Conclusions:

• Laparoscopic fenestration is a viable option for symptomatic APLD, especially for patients with predominantly large cysts.
• Its effectiveness is less than open surgery or liver resection.
• Repeat procedures are feasible, suggesting a role in long-term APLD management.