Minimally invasive laparoscopic surgery for liver cysts

  Hepatic cysts are a relatively common benign liver disease, the mechanism of which is mainly due to the developmental disorders of vagal bile ducts and lymphatic ducts in the liver during the embryonic period or local lymphatic ducts obstructed by inflammatory epithelial hyperplasia, resulting in the retention of secretions in the lumen of the ducts to form cysts. Depending on the cause, they can be classified into non-parasitic liver cysts and parasitic liver.  Liver cysts can be asymptomatic for a long time or for life due to slow growth and are often found incidentally during ultrasound examination. Their main clinical manifestations vary according to the location, size, number of cysts, the presence or absence of compression of adjacent organs and the presence or absence of complications. Simple hepatic cysts are relatively uncommon and the most common first symptom is increased abdominal girth. Other common clinical symptoms and signs are as follows: 1, gastrointestinal symptoms: when the cyst increases and compresses the stomach, duodenum and colon, it can cause postprandial fullness, loss of appetite, nausea and vomiting, etc.  2, abdominal pain: large and heavy cysts can cause epigastric swelling discomfort, vague pain or mild dull pain. Sudden onset of severe pain or signs and symptoms of peritonitis suggest the occurrence of complications such as cyst bleeding or rupture, and chills and fever may appear.  3, abdominal mass: the discovery of an abdominal mass is the main initial manifestation in many patients.  4.Jaundice: compression of the hepatic duct or common bile duct by the cyst adjacent to the hilar can cause mild jaundice, the incidence of which is low, occurring in only about 5% of cases.  5.Physical examination: abdominal mass moving with breathing is the main sign, the surface of the mass is smooth, usually hard, only part of it is cystic with fluctuating feeling. Its location depends on the site where the cyst occurs, but most of them are located in the right upper abdomen.  Liver cysts larger than 10 cm require surgical treatment, and in the past, most of them were treated by open surgery, requiring an incision of about 15 cm in the upper abdomen, which is very traumatic and slow in postoperative recovery, and patients may suffer from pain and incisional infection after surgery. I have widely adopted laparoscopic surgery for liver cysts based on a large number of laparoscopic surgeries, which only requires opening small holes of about 0, 5 cm in diameter in the abdomen. The surgery is less invasive, and the patient suffers less pain and recovers quickly. The procedure has been widely praised by patients.