Laparoscopic fenestration for the treatment of patients with severe adult polycystic liver disease
The purpose of this study was to present our experience in laparoscopic fenestration for patients with severe symptomatic adult polycystic liver disease (APLD), analyze its feasibility, and evaluate its immediate and mid-term outcome. Between January 2000 and January 2002, 9 patients underwent lapar...
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| Veröffentlicht in: | The American journal of surgery 2005, Vol.189 (1), p.71-75 |
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| creator | Konstadoulakis, Manousos M. Gomatos, Ilias P. Albanopoulos, Kostantinos Alexakis, Nikolaos Leandros, Emmanuel |
| description | The purpose of this study was to present our experience in laparoscopic fenestration for patients with severe symptomatic adult polycystic liver disease (APLD), analyze its feasibility, and evaluate its immediate and mid-term outcome.
Between January 2000 and January 2002, 9 patients underwent laparoscopic fenestration for symptomatic APLD in our laparoendoscopic unit. All patients had both liver lobes affected with multiple cysts, whereas type II disease (present in 8 patients) was not a contraindication for the procedure. The results were retrospectively evaluated.
Conversion to laparotomy was required in 1 patient who was submitted to a second laparoscopic procedure (2 years postoperatively) after being admitted to our department with sepsis. Complete regression of symptoms was achieved in 7 of our patients (77.8%). One death occurred because of acute renal failure established 5 weeks after the patient was discharged. During a mean follow-up of 25.8 months, 2 patients presented with recurrence of their symptoms (22.2%). One of them was reoperated on; both of them remain symptom free 14 months postoperatively.
Laparoscopic fenestration appears to be a useful and effective approach for severe APLD. It is associated with short hospital stay and a significant symptom-free period. Despite the reported morbidity, aggressive and meticulous deroofing of as many cysts as possible can be successfully applied for carefully selected patients with type II disease. |
| doi_str_mv | 10.1016/j.amjsurg.2004.03.011 |
| format | Article |
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Between January 2000 and January 2002, 9 patients underwent laparoscopic fenestration for symptomatic APLD in our laparoendoscopic unit. All patients had both liver lobes affected with multiple cysts, whereas type II disease (present in 8 patients) was not a contraindication for the procedure. The results were retrospectively evaluated.
Conversion to laparotomy was required in 1 patient who was submitted to a second laparoscopic procedure (2 years postoperatively) after being admitted to our department with sepsis. Complete regression of symptoms was achieved in 7 of our patients (77.8%). One death occurred because of acute renal failure established 5 weeks after the patient was discharged. During a mean follow-up of 25.8 months, 2 patients presented with recurrence of their symptoms (22.2%). One of them was reoperated on; both of them remain symptom free 14 months postoperatively.
Laparoscopic fenestration appears to be a useful and effective approach for severe APLD. It is associated with short hospital stay and a significant symptom-free period. Despite the reported morbidity, aggressive and meticulous deroofing of as many cysts as possible can be successfully applied for carefully selected patients with type II disease.</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/j.amjsurg.2004.03.011</identifier><identifier>PMID: 15701496</identifier><identifier>CODEN: AJSUAB</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Abdomen ; Adult ; Aged ; Aged, 80 and over ; APLD ; Biological and medical sciences ; Cysts ; Cysts - surgery ; Digestive System Surgical Procedures - methods ; Digestive system. Abdomen ; Disease ; Endoscopy ; General aspects ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Laparoscopic fenestration ; Laparoscopy ; Liver ; Liver diseases ; Liver Diseases - surgery ; Medical imaging ; Medical sciences ; Middle Aged ; Midterm outcome ; Patients ; Surgery ; Ultrasonic imaging</subject><ispartof>The American journal of surgery, 2005, Vol.189 (1), p.71-75</ispartof><rights>2005 Excerpta Medica Inc.</rights><rights>2005 INIST-CNRS</rights><rights>Copyright Elsevier Limited Jan 2005</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c449t-ff753c29563dc219933db885e741d94a629d4c92a55d29574a9757c395763e4b3</citedby><cites>FETCH-LOGICAL-c449t-ff753c29563dc219933db885e741d94a629d4c92a55d29574a9757c395763e4b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1444596336?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,4024,27923,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16568650$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15701496$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Konstadoulakis, Manousos M.</creatorcontrib><creatorcontrib>Gomatos, Ilias P.</creatorcontrib><creatorcontrib>Albanopoulos, Kostantinos</creatorcontrib><creatorcontrib>Alexakis, Nikolaos</creatorcontrib><creatorcontrib>Leandros, Emmanuel</creatorcontrib><title>Laparoscopic fenestration for the treatment of patients with severe adult polycystic liver disease</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>The purpose of this study was to present our experience in laparoscopic fenestration for patients with severe symptomatic adult polycystic liver disease (APLD), analyze its feasibility, and evaluate its immediate and mid-term outcome.
Between January 2000 and January 2002, 9 patients underwent laparoscopic fenestration for symptomatic APLD in our laparoendoscopic unit. All patients had both liver lobes affected with multiple cysts, whereas type II disease (present in 8 patients) was not a contraindication for the procedure. The results were retrospectively evaluated.
Conversion to laparotomy was required in 1 patient who was submitted to a second laparoscopic procedure (2 years postoperatively) after being admitted to our department with sepsis. Complete regression of symptoms was achieved in 7 of our patients (77.8%). One death occurred because of acute renal failure established 5 weeks after the patient was discharged. During a mean follow-up of 25.8 months, 2 patients presented with recurrence of their symptoms (22.2%). One of them was reoperated on; both of them remain symptom free 14 months postoperatively.
Laparoscopic fenestration appears to be a useful and effective approach for severe APLD. It is associated with short hospital stay and a significant symptom-free period. Despite the reported morbidity, aggressive and meticulous deroofing of as many cysts as possible can be successfully applied for carefully selected patients with type II disease.</description><subject>Abdomen</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>APLD</subject><subject>Biological and medical sciences</subject><subject>Cysts</subject><subject>Cysts - surgery</subject><subject>Digestive System Surgical Procedures - methods</subject><subject>Digestive system. Abdomen</subject><subject>Disease</subject><subject>Endoscopy</subject><subject>General aspects</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Laparoscopic fenestration</subject><subject>Laparoscopy</subject><subject>Liver</subject><subject>Liver diseases</subject><subject>Liver Diseases - surgery</subject><subject>Medical imaging</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Midterm outcome</subject><subject>Patients</subject><subject>Surgery</subject><subject>Ultrasonic imaging</subject><issn>0002-9610</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkV2L1DAUhoMo7uzqT1ACondTk-ajzZXIoqsw4I1eh0x66qa0TU3Slfn3nmEKC17oVU6SJy8n5yHkFWcVZ1y_Hyo3DXlNP6uaMVkxUTHOn5Adbxuz520rnpIdY6zeG83ZFbnOecAt51I8J1dcNYxLo3fkeHCLSzH7uARPe5ghl-RKiDPtY6LlHmhJ4MoEc6GxpwveYZnp71DuaYYHSEBdt46FLnE8-VMumDMGPKddyOAyvCDPejdmeLmtN-TH50_fb7_sD9_uvt5-POy9lKbs-75RwtdGadH5mhsjRHdsWwWN5J2RTtemk97UTqkOqUY606jGCyy1AHkUN-TdJXdJ8deK_7BTyB7G0c0Q12w1BmG4QPDNX-AQ1zRjb5ZLKZVBSP-TYoLXTBp2zlIXyuMQc4LeLilMLp0QsmdRdrCbKHsWZZmwaAHfvd7S1-ME3eOrzQwCbzfAZe_GPrnZh_zIaaVbrRhyHy4c4GgfAiSbPRry0IUEvtguhv-08gewPbMM</recordid><startdate>2005</startdate><enddate>2005</enddate><creator>Konstadoulakis, Manousos M.</creator><creator>Gomatos, Ilias P.</creator><creator>Albanopoulos, Kostantinos</creator><creator>Alexakis, Nikolaos</creator><creator>Leandros, Emmanuel</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>2005</creationdate><title>Laparoscopic fenestration for the treatment of patients with severe adult polycystic liver disease</title><author>Konstadoulakis, Manousos M. ; Gomatos, Ilias P. ; Albanopoulos, Kostantinos ; Alexakis, Nikolaos ; Leandros, Emmanuel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c449t-ff753c29563dc219933db885e741d94a629d4c92a55d29574a9757c395763e4b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Abdomen</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>APLD</topic><topic>Biological and medical sciences</topic><topic>Cysts</topic><topic>Cysts - surgery</topic><topic>Digestive System Surgical Procedures - methods</topic><topic>Digestive system. Abdomen</topic><topic>Disease</topic><topic>Endoscopy</topic><topic>General aspects</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Laparoscopic fenestration</topic><topic>Laparoscopy</topic><topic>Liver</topic><topic>Liver diseases</topic><topic>Liver Diseases - surgery</topic><topic>Medical imaging</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Midterm outcome</topic><topic>Patients</topic><topic>Surgery</topic><topic>Ultrasonic imaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Konstadoulakis, Manousos M.</creatorcontrib><creatorcontrib>Gomatos, Ilias P.</creatorcontrib><creatorcontrib>Albanopoulos, Kostantinos</creatorcontrib><creatorcontrib>Alexakis, Nikolaos</creatorcontrib><creatorcontrib>Leandros, Emmanuel</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Konstadoulakis, Manousos M.</au><au>Gomatos, Ilias P.</au><au>Albanopoulos, Kostantinos</au><au>Alexakis, Nikolaos</au><au>Leandros, Emmanuel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Laparoscopic fenestration for the treatment of patients with severe adult polycystic liver disease</atitle><jtitle>The American journal of surgery</jtitle><addtitle>Am J Surg</addtitle><date>2005</date><risdate>2005</risdate><volume>189</volume><issue>1</issue><spage>71</spage><epage>75</epage><pages>71-75</pages><issn>0002-9610</issn><eissn>1879-1883</eissn><coden>AJSUAB</coden><abstract>The purpose of this study was to present our experience in laparoscopic fenestration for patients with severe symptomatic adult polycystic liver disease (APLD), analyze its feasibility, and evaluate its immediate and mid-term outcome.
Between January 2000 and January 2002, 9 patients underwent laparoscopic fenestration for symptomatic APLD in our laparoendoscopic unit. All patients had both liver lobes affected with multiple cysts, whereas type II disease (present in 8 patients) was not a contraindication for the procedure. The results were retrospectively evaluated.
Conversion to laparotomy was required in 1 patient who was submitted to a second laparoscopic procedure (2 years postoperatively) after being admitted to our department with sepsis. Complete regression of symptoms was achieved in 7 of our patients (77.8%). One death occurred because of acute renal failure established 5 weeks after the patient was discharged. During a mean follow-up of 25.8 months, 2 patients presented with recurrence of their symptoms (22.2%). One of them was reoperated on; both of them remain symptom free 14 months postoperatively.
Laparoscopic fenestration appears to be a useful and effective approach for severe APLD. It is associated with short hospital stay and a significant symptom-free period. Despite the reported morbidity, aggressive and meticulous deroofing of as many cysts as possible can be successfully applied for carefully selected patients with type II disease.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>15701496</pmid><doi>10.1016/j.amjsurg.2004.03.011</doi><tpages>5</tpages></addata></record> |
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| subjects | Abdomen Adult Aged Aged, 80 and over APLD Biological and medical sciences Cysts Cysts - surgery Digestive System Surgical Procedures - methods Digestive system. Abdomen Disease Endoscopy General aspects Humans Investigative techniques, diagnostic techniques (general aspects) Laparoscopic fenestration Laparoscopy Liver Liver diseases Liver Diseases - surgery Medical imaging Medical sciences Middle Aged Midterm outcome Patients Surgery Ultrasonic imaging |
| title | Laparoscopic fenestration for the treatment of patients with severe adult polycystic liver disease |
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