Complete laparoscopic excision of a hepatic cyst and omentopexy in a Persian cat

Abstract

Case summary Congenital or acquired hepatic cystic lesions in cats are a rare condition. Congenital hepatic cysts are often present as part of a systemic polycystic disease involving several organs. Most cats with hepatic cysts remain clinically normal for their lives, although some patients may show abdominal distension, vomiting, abdominal pain and jaundice. An 11-year-old female neutered Persian cat was presented to our institution 3 days after the onset of inappropriate defecation and urination. This patient had a history of polycystic kidney disease and a small hepatic cystic lesion. Physical examination showed pain on abdominal palpation. Abdominal ultrasonography revealed an increase in the size of the hepatic cyst and a partial obstruction of the biliary tract. Owing to the progression of the hepatic cyst, laparoscopic excision and omentalisation were performed. The cyst was completely resected using a 5 mm laparoscopic vessel sealer/divider device. It was removed from the abdomen through one of the portals and was submitted for histological study. After cyst excision, omentopexy was performed using 4-0 USP braided absorbable material. At follow-up examination 5 days later, the physical examination was normal and abdominal palpation was not painful. A biopsy report confirmed the diagnosis of a liver cyst. A follow-up abdominal ultrasonography performed 6 months after surgery revealed no recurrence of the liver cyst. Relevance and novel information To our knowledge, this is the first case report describing the laparoscopic technique of liver cystectomy and omentopexy in veterinary medicine. Minimally invasive surgery is gaining widespread acceptance within the veterinary community because of its benefits. However, further investigation with prospective studies are necessary.