Skip to main content
PMC home page
The Ulster Medical Journal logoLink to The Ulster Medical Journal
. 2002 Nov;71(2):106–110.

Management of symptomatic liver cysts.

A Pitale 1, A K Bohra 1, T Diamond 1
PMCID: PMC2475301  PMID: 12513006

Abstract

Non-parasitic liver cysts are seen in up to 5% of the population. They become symptomatic when they are large and can cause pain, nausea, vomiting, early satiety and obstructive jaundice. Treatment modalities include percutaneous drainage, open deroofing, hepatic resection and lately, laparoscopic deroofing. We assessed our management of eleven symptomatic patients over the last five years between May 1996 and August 2001. Two of these had mild symptoms and were kept under review. The remaining nine were treated surgically. Of these, eight were treated by laparotomy and open deroofing with argon laser coagulation of the cut edges while one was treated with left hepatic resection. Three of these had been previously treated with laparoscopic deroofing at other hospitals and had been referred after having developed recurrent symptomatic cysts. Two patients developed post-operative complications--bile leakage that resolved with conservative management. The patients were followed up for a median period of twelve months ranging from 3-62 months. One patient died of liver failure 12 months after surgery. There was no symptomatic recurrence. We conclude that open cyst deroofing gives marked symptomatic relief with a very low complication rate. In today's era of laparoscopic surgery, it has a definite role in the management of symptomatic liver cysts, more so in recurrent cysts following laparoscopic treatment.

Full text

PDF
106

Images in this article

108Fig 1
on p.108
108Fig 2
on p.108

Selected References

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

  1. Caremani M., Vincenti A., Benci A., Sassoli S., Tacconi D. Ecographic epidemiology of non-parasitic hepatic cysts. J Clin Ultrasound. 1993 Feb;21(2):115–118. doi: 10.1002/jcu.1870210207. [DOI] [PubMed] [Google Scholar]
  2. Diez J., Decoud J., Gutierrez L., Suhl A., Merello J. Laparoscopic treatment of symptomatic cysts of the liver. Br J Surg. 1998 Jan;85(1):25–27. doi: 10.1046/j.1365-2168.1998.02870.x. [DOI] [PubMed] [Google Scholar]
  3. Doty J. E., Tompkins R. K. Management of cystic disease of the liver. Surg Clin North Am. 1989 Apr;69(2):285–295. doi: 10.1016/s0039-6109(16)44786-9. [DOI] [PubMed] [Google Scholar]
  4. Edwards J. D., Eckhauser F. E., Knol J. A., Strodel W. E., Appelman H. D. Optimizing surgical management of symptomatic solitary hepatic cysts. Am Surg. 1987 Sep;53(9):510–514. [PubMed] [Google Scholar]
  5. Kasai Y., Sasaki E., Tamaki A., Koshino I., Kawanishi N. Carcinoma arising in the cyst of the liver--report of three cases--. Jpn J Surg. 1977 Jun;7(2):65–72. doi: 10.1007/BF02469388. [DOI] [PubMed] [Google Scholar]
  6. Klingler P. J., Gadenstätter M., Schmid T., Bodner E., Schwelberger H. G. Treatment of hepatic cysts in the era of laparoscopic surgery. Br J Surg. 1997 Apr;84(4):438–444. [PubMed] [Google Scholar]
  7. 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]
  8. Larssen T. B., Viste A., Jensen D. K., Søndenaa K., Røkke O., Horn A. Single-session alcohol sclerotherapy in benign symptomatic hepatic cysts. Acta Radiol. 1997 Nov;38(6):993–997. doi: 10.1080/02841859709172116. [DOI] [PubMed] [Google Scholar]
  9. Lin T. Y., Chen C. C., Wang S. M. Treatment of non-parasitic cystic disease of the liver: a new approach to therapy with polycystic liver. Ann Surg. 1968 Nov;168(5):921–927. doi: 10.1097/00000658-196811000-00022. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Madariaga J. R., Iwatsuki S., Starzl T. E., Todo S., Selby R., Zetti G. Hepatic resection for cystic lesions of the liver. Ann Surg. 1993 Nov;218(5):610–614. doi: 10.1097/00000658-199321850-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Montorsi M., Torzilli G., Fumagalli U., Bona S., Rostai R., De Simone M., Rovati V., Mosca F., Filice C. Percutaneous alcohol sclerotherapy of simple hepatic cysts. Results from a multicentre survey in Italy. HPB Surg. 1994;8(2):89–94. doi: 10.1155/1994/10372. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Paterson-Brown S., Garden O. J. Laser-assisted laparoscopic excision of liver cyst. Br J Surg. 1991 Sep;78(9):1047–1047. doi: 10.1002/bjs.1800780907. [DOI] [PubMed] [Google Scholar]
  13. Polysalov V. N., Oleshchuk N. V. Punktsionnoe skleroziruiushchee lechenie neparazitarnykh kist pecheni. Vestn Khir Im I I Grek. 1997;156(5):78–80. [PubMed] [Google Scholar]
  14. Que F., Nagorney D. M., Gross J. B., Jr, Torres V. E. Liver resection and cyst fenestration in the treatment of severe polycystic liver disease. Gastroenterology. 1995 Feb;108(2):487–494. doi: 10.1016/0016-5085(95)90078-0. [DOI] [PubMed] [Google Scholar]
  15. Sanchez H., Gagner M., Rossi R. L., Jenkins R. L., Lewis W. D., Munson J. L., Braasch J. W. Surgical management of nonparasitic cystic liver disease. Am J Surg. 1991 Jan;161(1):113–119. doi: 10.1016/0002-9610(91)90370-s. [DOI] [PubMed] [Google Scholar]
  16. 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]
  17. The polycystic kidney disease 1 gene encodes a 14 kb transcript and lies within a duplicated region on chromosome 16. The European Polycystic Kidney Disease Consortium. Cell. 1994 Jun 17;77(6):881–894. doi: 10.1016/0092-8674(94)90137-6. [DOI] [PubMed] [Google Scholar]
  18. Zacherl J., Scheuba C., Imhof M., Jakesz R., Függer R. Long-term results after laparoscopic unroofing of solitary symptomatic congenital liver cysts. Surg Endosc. 2000 Jan;14(1):59–62. doi: 10.1007/s004649900012. [DOI] [PubMed] [Google Scholar]

Articles from The Ulster Medical Journal are provided here courtesy of Ulster Medical Society

RESOURCES