Laparoscopic right hemihepatectomy for a case of polycystic liver disease with right predominance

Background/Purpose. A case of polycystic liver disease with right predominance treated with laparoscopic right hemihepatectomy is described. Patient. A 43-year-old woman complaining of right upper abdominal pain came in for consultation. Abdominal ultrasonography and computed tomography studies showed multiple liver cysts occupying mainly the right lobe, renal cysts, and splenomegaly. Methods. Four trocars were used. A 12-mm trocar placed under the umbilicus was used for abdominal exploration. The other three trocars, two 12-mm trocars and one 5-mm trocar, were used as working ports. The liver was transected with ultrasound scissors and LigaSure. Major vessels such as the right portal vein, the right bile duct, and the hepatic vein were divided with a vascular endostapler. Operation time was 320 min, intraoperative blood loss was 120 ml, and postoperative oral intake occurred on day 3. Results. No complication was observed during the perioperative period. Conclusions. Laparoscopic right hemihepatectomy is generally considered to cause excessive intraoperative bleeding and a long operation time. For our patient with multiple liver cysts, the procedure was a safe and minimally invasive option because little hepatic parenchymal resection was necessary for the multiple cysts.