Year: 2025
Type: article
Abstract: . The feasibility of performing simultaneous surgeries using video-laparoscopic techniques for the treatment of combined abdominal diseases has been repeatedly highlighted in both domestic and international studies. Aim: To enhance the outcomes of surgical treatment in patients with a combination of gallstone disease and nonparasitic liver cysts through the comprehensive application of laparoscopic technologies. Materials and Methods. The study analyzed the treatment outcomes of 32 patients who underwent simultaneous laparoscopic procedures for gallstone disease combined with nonparasitic liver cysts. Alongside laparoscopic cholecystectomy, 8 patients underwent cystectomy, while 24 patients underwent cyst fenestration with de-epithelialization of the intraparenchymal portion of the cyst. The surgical procedures involved the use of electrosurgical instruments, an ultrasonic scalpel, and an Endo-GIA linear stapler. Results and Discussion. A significant difference was observed in the laparoscopic findings following electrocautery de-epithelialization of the intraparenchymal portion of the cyst (5 patients) compared to treatment with an ultrasonic scalpel (19 patients). After electrosurgical treatment, the remaining cyst wall appeared as a solid area of coagulative necrosis, whereas ultrasonic treatment resulted in only mild tissue edema with signs of inflammation and no thermal damage. In 4 patients with thick cyst walls, an Endo-GIA endoscopic linear stapler was used in addition to ultrasonic dissection. In 11 patients with cysts larger than 10 cm. cystopexy was performed after de-epithelialization of the residual cyst cavity. Long-term follow-up (ranging from 6 months to 10 years) showed no recurrences or residual cavities. Conclusions. Laparoscopic fenestration of nonparasitic liver cysts with subsequent de-epithelialization of the residual cyst cavity is an effective and safe treatment method that can be performed as a standalone procedure or as part of a simultaneous operation. The combined use of an ultrasonic scalpel and a linear stapler in laparoscopic fenestration of nonparasitic liver cysts helps reduce intraoperative blood loss and prevents intraand postoperative complications, ultimately improving treatment outcomes for this patient group.
Source: Kharkiv Surgical School
Authors: S. O. Bychkov, O. O. Martuniv
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4410599133