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. 1993 Nov;218(5):610–614. doi: 10.1097/00000658-199321850-00004

Hepatic resection for cystic lesions of the liver.

J R Madariaga 1, S Iwatsuki 1, T E Starzl 1, S Todo 1, R Selby 1, G Zetti 1
PMCID: PMC1243030  PMID: 8239774

Abstract

OBJECTIVE. The purpose of this study was to report the authors' experience with hepatic resection for cystic lesions of the liver. SUMMARY BACKGROUND DATA. Past experience with aspiration, sclerosing therapy, internal drainage, fenestration, and marsupialization are of limited value. Hepatic resection has evolved into a safe operation over the last two decades. METHODS. A retrospective study of 44 patients with various cystic lesions of the liver (polycystic disease, 2; solitary or multiple congenital cysts, 19; biliary cystadenoma, 6; cystadenocarcinoma, 3; squamous cell carcinoma, 3; Caroli's disease, 5; and hydatid cyst, 6) was performed. RESULTS. After 7 trisegmentectomies, 24 lobectomies, 6 left lateral segmentectomies, and 7 nonanatomical hepatic resections, only 1 operative death occurred in a Jehovah's Witness. Symptomatic relief was complete and permanent in all of the patients with benign congenital or parasitic hepatic cysts, except for the two patients with polycystic disease of the liver. One of the 3 patients with adenocarcinoma and 3 patients with squamous cell carcinoma of the cyst wall died of tumor recurrence between 3 and 14 months after hepatic resection. CONCLUSIONS. Hepatic resection is safe and effective for cystic lesions of the liver. Symptomatic relief is complete and permanent after hepatic resection, except in cases of diffuse polycystic disease of the liver. Liver transplantation should be considered for diffuse polycystic disease of the liver when the symptoms are extremely severe.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Andersson R., Jeppsson B., Lunderquist A., Bengmark S. Alcohol sclerotherapy of non-parasitic cysts of the liver. Br J Surg. 1989 Mar;76(3):254–255. doi: 10.1002/bjs.1800760313. [DOI] [PubMed] [Google Scholar]
  2. Armitage N. C., Blumgart L. H. Partial resection and fenestration in the treatment of polycystic liver disease. Br J Surg. 1984 Mar;71(3):242–244. doi: 10.1002/bjs.1800710331. [DOI] [PubMed] [Google Scholar]
  3. Bloustein P. A. Association of carcinoma with congenital cystic conditions of the liver and bile ducts. Am J Gastroenterol. 1977 Jan;67(1):40–46. [PubMed] [Google Scholar]
  4. Bloustein P. A., Silverberg S. G. Squamous cell carcinoma originating in an hepatic cyst. Case report with a review of the hepatic cyst-carcinoma association. Cancer. 1976 Nov;38(5):2002–2005. doi: 10.1002/1097-0142(197611)38:5<2002::aid-cncr2820380523>3.0.co;2-9. [DOI] [PubMed] [Google Scholar]
  5. Ishak K. G., Willis G. W., Cummins S. D., Bullock A. A. Biliary cystadenoma and cystadenocarcinoma: report of 14 cases and review of the literature. Cancer. 1977 Jan;39(1):322–338. doi: 10.1002/1097-0142(197701)39:1<322::aid-cncr2820390149>3.0.co;2-p. [DOI] [PubMed] [Google Scholar]
  6. Iwatsuki S., Sheahan D. G., Starzl T. E. The changing face of hepatic resection. Curr Probl Surg. 1989 May;26(5):281–379. doi: 10.1016/0011-3840(89)90022-1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Iwatsuki S., Starzl T. E. Personal experience with 411 hepatic resections. Ann Surg. 1988 Oct;208(4):421–434. doi: 10.1097/00000658-198810000-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Iwatsuki S., Todo S., Starzl T. E. Excisional therapy for benign hepatic lesions. Surg Gynecol Obstet. 1990 Sep;171(3):240–246. [PMC free article] [PubMed] [Google Scholar]
  9. Lai E. C., Wong J. Symptomatic nonparasitic cysts of the liver. World J Surg. 1990 Jul-Aug;14(4):452–456. doi: 10.1007/BF01658666. [DOI] [PubMed] [Google Scholar]
  10. Lynch M. J., McLeod M. K., Weatherbee L., Gilsdorf J. R., Guice K. S., Eckhauser F. E. Squamous cell cancer of the liver arising from a solitary benign nonparasitic hepatic cyst. Am J Gastroenterol. 1988 Apr;83(4):426–431. [PubMed] [Google Scholar]
  11. Newman K. D., Torres V. E., Rakela J., Nagorney D. M. Treatment of highly symptomatic polycystic liver disease. Preliminary experience with a combined hepatic resection-fenestration procedure. Ann Surg. 1990 Jul;212(1):30–37. doi: 10.1097/00000658-199007000-00005. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Saini S., Mueller P. R., Ferrucci J. T., Jr, Simeone J. F., Wittenberg J., Butch R. J. Percutaneous aspiration of hepatic cysts does not provide definitive therapy. AJR Am J Roentgenol. 1983 Sep;141(3):559–560. doi: 10.2214/ajr.141.3.559. [DOI] [PubMed] [Google Scholar]
  13. Sanfelippo P. M., Beahrs O. H., Weiland L. H. Cystic disease of the liver. Ann Surg. 1974 Jun;179(6):922–925. doi: 10.1097/00000658-197406000-00018. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Starzl T. E., Bell R. H., Beart R. W., Putnam C. W. Hepatic trisegmentectomy and other liver resections. Surg Gynecol Obstet. 1975 Sep;141(3):429–437. [PMC free article] [PubMed] [Google Scholar]
  15. Starzl T. E., Iwatsuki S., Shaw B. W., Jr, Waterman P. M., Van Thiel D., Diliz H. S., Dekker A., Bron K. M. Left hepatic trisegmentectomy. Surg Gynecol Obstet. 1982 Jul;155(1):21–27. [PMC free article] [PubMed] [Google Scholar]
  16. Starzl T. E., Koep L. J., Weil R., 3rd, Lilly J. R., Putnam C. W., Aldrete J. A. Right trisegmentectomy for hepatic neoplasms. Surg Gynecol Obstet. 1980 Feb;150(2):208–214. [PMC free article] [PubMed] [Google Scholar]
  17. Starzl T. E., Reyes J., Tzakis A., Mieles L., Todo S., Gordon R. Liver transplantation for polycystic liver disease. Arch Surg. 1990 May;125(5):575–577. doi: 10.1001/archsurg.1990.01410170021003. [DOI] [PubMed] [Google Scholar]
  18. van Erpecum K. J., Janssens A. R., Terpstra J. L., Tjon A Tham R. T. Highly symptomatic adult polycystic disease of the liver. A report of fifteen cases. J Hepatol. 1987 Aug;5(1):109–117. doi: 10.1016/s0168-8278(87)80068-5. [DOI] [PubMed] [Google Scholar]

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