Il trattamento del cistoadenoma incidentale dopo chirurgia laparoscopica delle lesioni cistiche benigne del fegato

Although a diagnosis of cystadenoma during open hepatic surgery demands a complete surgical resection, few reports described thè correct approach to such lesions, when the diag¬nosis of BC has been obtained after a laparoscopic fenestration of a cystic liver lesion. Methods: In the period 1996-2003, 20 patients with a no parasitic cyst of the liver were selected for laparoscopic liver surgery. Pathologies included solitary giant liver cyst in 13 patients, multicystic liver disease in 1 patient, and polycystic liver disease in 6 patients. Results: In three patients, the histopathologic examination re-vealed a cystadenoma. One patient with polycystic liver disease declined thè surgical intervention. No evidence of recurrence was found during thè 24-month follow-up. One patient with a 13-cm cyst had been undergone a complete enucleation of the lesion, with no evidence of recurrence 18 months after the laparoscopic procedure. One patient with multicystic liver, suffered of a recurrence that was treated with an open hepatic resection. Histopathologic examina¬tion of the specimen did not reveal any signs of cys¬tadenoma. Conclusions: The incidental finding of BC after laparoscopic fenestration of a cystic hepatic le¬sion requires an open hepatic resection. When a com¬plete laparoscopic enucleation of the cyst may be as-sured, a strict follow-up should be considered as the definitive treatment, demanding the surgical inter¬vention only in case of recurrence or high suspicion for malignancy.