Perioperative management - Laparoscopic unroofing of simple liver cyst

Symptomatic liver cysts: (Fatigue, breathing problems, sensation of pressure/abdominal fullness, nausea, organ displacement induced pain, icterus due to compression of the intra-/extrahepatic bile ducts).

• Solitary nonparasitic benign liver cysts
• Polycystic liver lesions type I (limited number of large cysts on hepatic surface)

• Asymptomatic cysts
• Polycystic liver lesions type II (numerous small cysts in the entire liver)
• Neoplastic cysts (cystadenoma, cystadenocarcinoma)

Relative contraindications include:

• Parasitic liver cysts
• Location: posterior liver segments I, VII, VIII
• Major coagulation disorders
• Cardiopulmonary risk factors
• Cirrhosis

Patient history and clinical examination

Abdominal CT or MRI studies

Lab studies (liver function, serum antibody screening for echinococcosis)

General risks:

• Allergy
• Thrombosis
• Embolism
• Cardiovascular reactions
• Pneumonia
• Blood transfusion
• Incisional hernia

Special risks:

• Wound infection
• Intra-abdominal infection
• Secondary bleeding
• Ascites
• Pleural effusion
• Biliary leaks
• Recurrent cyst with recurrent symptoms