Laparoscopic fenestration of giant hepatic cysts.

Laparoscopic fenestration has become the standard of care for nonparasitic cysts of the liver, both solitary and multiple. In this case report, we describe the laparoscopic fenestration of 2 giant hepatic cysts that were greater than 25 cm in largest diameter, and resulted in significant compression of adjacent structures, including the biliary tree and inferior vena cava. In particular, the technical considerations of port placement and cyst wall removal will be addressed.