Laparoscopic Fenestration of Symptomatic Hepatic Cysts: A Clinical Case Series

Abstract

Background: Hepatic cysts of significant volume present technical challenges regarding surgical exposure and postoperative recovery. This study evaluates the clinical characteristics and outcomes of laparoscopic deroofing. Methods: A descriptive case series was conducted on six patients with giant simple hepatic cysts. Data regarding clinical presentations, imaging, intraoperative maneuvers, and postoperative recovery trajectories were analyzed. Results: The cohort comprised 6 patients (4 females, 2 males) aged 48–71 years. Cysts were predominantly located in the posterosuperior segments (S7, S8) in 66.7% of cases. All cysts exceeded 70 mm in maximal diameter (range: 73–108 mm), with 33.3% exhibiting turbid fluid. Preoperative liver function remained stable (mean AST/ALT: 24.3/22.1 U/L; total bilirubin: 8.5 µmol/L). Laparoscopic deroofing with Ligasure was successfully performed in 100% of cases. For one patient (16.7%), a 90-degree left lateral decubitus position was utilized to optimize exposure of deep-seated lesions. The mean postoperative hospital stay was 3.3 days (range: 2–4 days). No complications or symptomatic recurrences were observed during follow-up. Conclusions: Laparoscopic deroofing using Ligasure is a safe and effective intervention for giant hepatic cysts. Strategic intraoperative positioning optimizes surgical exposure and accelerates functional recovery.