Laparoscopic hepatectomy for the treatment of Caroli's disease: a case report

Caroli disease is a rare congenital disorder characterized by nonobstructive dilatation of intrahepatic ducts. In cases with symptomatic intrahepatic manifestations, treatment should correspond to the type with hepatic resection for localized disease and transplantation for diffuse forms. If possible, complete resection of the cysts can cure the symptoms and avoid the risk of malignancy. A 66-year-old woman presented to Wuxi Xishan People's Hospital with recurrent intermittent upper quadrant abdominal pain. Further examinations suggested the diagnosis of Caroli disease limited to the left hepatic lobe. She underwent laparoscopic hepatectomy. Pathological examination confirmed the diagnosis of Caroli disease, and no malignancy was found. There were no immediate complications and no long-term complications after one and one-half years of follow-up. Laparoscopic hepatectomy could be a feasible, safe treatment option for localized Caroli disease.

investigation for public acceptance of laparoendoscopic single-site surgery

Laparoendoscopic single-site surgery [LESS] is the latest innovation in minimally invasive surgery with unconfirmed advantages. The public perception of LESS is the basis of carrying out the surgery. Participants from the outpatient department were invited to rate, on a 5-point Likert scale, the important factors including scar, complications, cost, pain and hospital stay in choosing surgery. In addition, those who preferred LESS would continue to make their choices as the risks of LESS in above mentioned aspects rose. About 85% of the questionnaires were included in the analysis. Complication was the most important factor with an average score of 4.77 +/- 0.43, followed by pain [3.84 +/- 0.96], scar [3.57 +/- 1.17], cost [3.41 +/- 0.87] and hospital stay [3.04 +/- 0.86]. Of the 196 participants, 132 [67%] preferred LESS with younger age [35.3 +/- 10.64 versus 40.4 +/- 9.6, P=0.001]. Better cosmesis was the only factor that made the participants choose LESS [3.78 +/- 1.11 versus 3.13 +/- 1.19, P < 0.005]. Almost 90% of the participants could accept the hypothesis [incision length of 3.5cm, cost up to 120%, pain up to 120%, hospital stay of 5 days], while only 50% of participants could accept the risk of complications of 6%. Complication is the most important factor that the public are concerned about in choosing surgery. LESS is preferred by young who care more concerned about the cosmesis, even with moderately elevated risks of extending incision and increasing hospital cost, postoperative pain and hospital stay