■ Although unroofing is simple, enucleation carries risk of hemorrhage. Make certain the hepatic duct and ligament is accessible for a Pringle maneuver if needed.
■ Look for small biliary radicals after enucleation; drainage is not a good alternative to repair or suture ligation.
■ During laparoscopic resection of hepatic cysts, be aware that major pedicles may not be amenable to sealing devices. Surgical staplers are still the best mechanism to secure structures.
■ Like in any laparoscopic procedure with potential bleeding, do not hesitate to open up the patient in the presence of significant bleeding. Safety is still better than pride!
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For centuries, ever since the legendary Ponce de Leon went searching for the elusive Fountain of Youth, people have been looking for ways to slow down the aging process. Medical science has made great strides in keeping people alive longer by preventing and curing disease, and helping people to live healthier lives. Average life expectancy keeps increasing, and most of us can look forward to the chance to live much longer lives than our ancestors.