Endovideosurgery Potential in the Treatment of Liver Cysts

Non-parasitic cystic lesions of the liver are asymptomatic for a long time and appear to be an accidental diagnostic finding. It should also be noted that when choosing a treatment strategy, it is necessary to carry out differential diagnostics with parasitic cysts in echinococcosis and opisthorchiasis, as well as decay areas in alveococcosis and liver cancer. The paper describes a clinical case of successful management of a patient with a liver cyst. Prior to admission, the patient was examined outpatiently: ultrasound examination, spiral computed tomography of the abdominal organs detected a liquid formation in the projection of liver segments II–III measuring 89x79x88 mm. In addition, immunological studies were carried out to differentiate the origin of cystic formation. The presence of IgG antibodies to Toxocara was confirmed, the fact allowing for the parasitic origin of the cyst. The patient was admitted to the Surgical Clinic named after I.I. Grekov, North-Western State Medical University named after I.I. Mechnikov, for planned surgical treatment - en bloc resection of liver segments II-III and cholecystectomy, due to concomitant cholelithiasis. The resected edge of the liver and the gallbladder bed were processed using argon plasma coagulation. The postoperative period appeared unremarkable. The histopathological examination finding was a solitary cyst of the bile duct, with chronic active inflammation in the surrounding liver tissue. The patient was discharged in a satisfactory condition on the eleventh day after the operation under the supervision of a surgeon, therapist and infectious disease specialist. Thus, an interdisciplinary approach is a key in the treatment of patients with liver cysts and allows choosing the optimal treatment tactics.
Endovideosurgical technologies allow conducting radical surgical interventions for liver cysts, even in cases when their parasitic origin cannot be excluded.