Laparoscopic Management of a Symptomatic Giant Simple Hepatic Cyst Presenting with Chronic Right Hypochondrial Discomfort and Dyspepsia: A Case Report with Excellent Clinical Outcome
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Abstract
Background: Simple hepatic cysts are common benign liver lesions that are usually asymptomatic and incidentally detected. Giant hepatic cysts, however, may cause significant symptoms due to compression of adjacent organs, warranting surgical intervention. Minimally invasive approaches have become the standard of care for symptomatic simple hepatic cysts.
Case Presentation: A 55-year-old hypertensive woman presented with a one-year history of progressive right hypochondrial discomfort, abdominal distension, dyspepsia, and loss of appetite, without systemic symptoms or features of liver dysfunction. Imaging studies revealed a giant exophytic simple hepatic cyst arising from the posterior segments of the right lobe of the liver, measuring up to 15.5 cm with an estimated volume of 1276 mL. After preoperative optimization and cardiology consultation, laparoscopic cyst aspiration and wide deroofing were performed. Approximately 1400 mL of straw-colored fluid was aspirated. Histopathology confirmed a simple hepatic cyst. The postoperative course was uneventful, with complete symptomatic relief and no evidence of recurrence on follow-up.
Conclusion: Laparoscopic deroofing is a safe, effective, and minimally invasive treatment for symptomatic giant simple hepatic cysts, providing excellent clinical outcomes with low morbidity.
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References
I. Caremani, M., Vincenti, A., Benci, A., Sassoli, S., and Tacconi, D. 1993. Ecographic epidemiology of non-parasitic hepatic cysts. J Clin Ultrasound. 1993, 21(2): 115-118.
II. Cowles, R.A., and Mulholland, M.W. 2000. Solitary hepatic cysts. J Am Coll Surg. 2000, 191(3): 311-321.
III. Gigot, J.F., Legrand, M., Hubens, G., et al. 1996. Laparoscopic treatment of nonparasitic liver cysts: adequate selection of patients and surgical technique. World J Surg. 1996, 20(5): 556-561.
IV. Martin, I.J., McKinley, A.J., Currie, E.J., Holmes, P., and Garden, O.J. 1998. Tailoring the management of nonparasitic liver cysts. Ann Surg. 1998, 228(2): 167-172.
V. Zacherl, J., Scheuba, C., Imhof, M., et al. 2000. Long-term results after laparoscopic unroofing of solitary liver cysts. Surg Endosc. 2000, 14(1): 59-62.
VI. European Association for the Study of the Liver (EASL). EASL Clinical Practice Guidelines on the management of benign liver tumours. J Hepatol. 2016, 65(2): 386-398.
VII. Marrero, J.A., Ahn, J., and Reddy, K.R. 2014. ACG clinical guideline: the diagnosis and management of focal liver lesions. Am J Gastroenterol. 2014, 109(9): 1328-1347.