Complications arising in simple and polycystic liver cysts (original) (raw)

Pattern of liver cysts with their surgical management

International Journal of Research in Medical Sciences, 2022

Background: Liver cysts are seen in up to 5% of the population. 15-16% of such cysts are symptomatic. Symptomatic cysts are found more commonly in women who are over 50 years of age. Simple hepatic cysts are believed to be congenital in origin. Methods: The observational study was conducted in the department of hepatobiliary department of surgery of

Diagnostic and Therapeutic Challenges in Nonparasitic Liver Cysts

Recent Advances in Liver Diseases and Surgery, 2015

Nonparasitic hepatic cysts constitute a heterogeneous group of disorders. A proper diagnosis of hepatic cyst is necessary in order to adopt the best treatment. The term hepatic cyst usually refers to simple hepatic cysts. Nonparasitic hepatic cysts are also linked to genetic disorders such as polycystic liver disease (PLD) with/ without autosomal dominant polycystic kidney disease (ADPKD) or Caroli disease. Generally, patients with nonparasitic hepatic cysts less than 3 cm are asymptomatic. These cysts become symptomatic when are large, multiple, or complicated. Percutaneous abdominal ultrasound is the best imaging modality to diagnose hepatic cysts but must be completed by other imaging and serological tests. It is important to differentiate simple hepatic cyst from hydatid cyst, cystadenoma, and cystadenocarcinoma before proceeding with the treatment. Sometimes the diagnosis is very challenging. Asymptomatic single liver cysts need only surveillance, but symptomatic and complicated ones require therapeutic intervention. Percutaneous aspiration of the cyst under ultrasound guidance is a mini-invasive procedure generally associated with sclerotherapy. The highest success rates were reported for laparoscopic or open cyst fenestration. Liver transplantation is indicated for patients with severe PLD.

Management of Nonparasitic Hepatic Cysts

Journal of the American College of Surgeons, 2009

BACKGROUND: The optimal management of nonparasitic hepatic cysts (NPHC) is a topic of debate. The purpose of this study was to evaluate our 17-year experience with NPHC. STUDY DESIGN: From consecutive patients with NPHC were evaluated and treated at our institution. Seventy-eight patients (60%) had simple hepatic cysts (SHC). The remaining 53 (40%) had polycystic liver disease (PLD). Morbidity, mortality, and recurrence rates for each of the two groups were evaluated.

Management and long-term follow-up of hepatic cysts

The American Journal of Surgery, 2001

To provide an algorithm for the management of hepatic cysts through an analysis of our series over 16 years. Method: We reviewed the surgical management and outcome of patients with hepatic cysts between 1984 and 2000 at a single institution. Data were collected by chart review, telephone interview, and follow-up hepatic ultrasonography. Results: Forty-four patients (36 females, 8 males) underwent a total of 46 operations for hepatic cysts (mean size 12.0 Ϯ 5.2 cm) with a mean follow-up of 5.1 Ϯ 4.0 years. We treated 28 simple cysts, 4 polycystic liver disease (PCLD), 7 cystadenomas, 2 hydatid cysts, 1 cystadenocarcinoma, 1 endometrioma, and 1 hepatic foregut cyst. Operations included simple drainage, wide unroofing (open and laparoscopic), and hepatic resection. Four patients experienced a symptomatic recurrence after definitive treatment; 3 of these patients had PCLD. Four of the 7 patients with cystadenomas had undergone previous operations that required subsequent definitive resection without a recurrence. Conclusions: The preoperative distinction between simple cysts and cystadenomas/cystadenocarcinomas can be difficult, yet the management is different. Unroofing is a safe and effective operation for patients with simple cysts. Patients with PCLD frequently have recurrences. Cystadenomas should be completely resected owing to the likelihood of recurrence after partial excision and the risk of eventual cystadenocarcinoma. We present a treatment algorithm for the preoperative evaluation and management of hepatic cysts based on the largest number of patients with the longest follow-up reported to date.

Nonparasitic cysts of the liver: laparoscopic treatment and long-term results

Annali italiani di chirurgia

In the current debate on the indications for the laparoscopic treatment of symptomatic simple hepatic cysts, we emphasize the importance of the exact indications, practicing in an area endemic for hepatic hydatidosis. 8 years ago we started treating laparoscopically the simple hepatic cysts and the polycystosis. Although the laparoscopic approach to parasitic hepatic cysts has been recently introduced, this method has to be the result of a conscious choice and with a presumptive diagnosis to support it. In fact, reviewing the literature on the subject, we realized how most of the intraoperative complications were due to an erroneous preoperative diagnosis, likely to be attributed to the infrequent observation of hepatic hydatid disease. Hence, it seems of primary importance to review the subject in light of the potential dangerous aspect of the laparoscopic approach. From 1992 to 2000 we treated 38 cases of benign liver cystic disease (29 echinococcal cysts, 8 symptomatic simple cys...

Minimally invasive management of hepatic cysts: indications and complications

European review for medical and pharmacological sciences, 2018

OBJECTIVE Liver cysts are divided into congenital and acquired. Congenital cystic lesions include polycystic liver disease, simple cysts, duct related and ciliated hepatic foregut cysts. Acquired cystic lesions are divided into infectious and non-infectious. The infectious cysts are the hydatid cyst, the amoebic abscess, and the pyogenic abscess, whereas the non-infectious cysts are neoplastic cysts and false cysts. While modern medicine provides a lot of minimally invasive therapeutic modalities, there has emerged a pressing need for understanding the various types of liver cysts, the possible minimal therapeutic options along with their indications and complications. We aim is to clarify the role of minimally invasive techniques in the management of hepatic cysts. MATERIALS AND METHODS A literature review was performed using the MEDLINE database. The search terms were: liver cyst, minimally invasive, laparoscopic, percutaneous, drainage and fenestration. We reviewed 82 English lan...

Laparoscopic treatment of simple hepatic cysts and polycystic liver disease

Surgical Endoscopy And Other Interventional Techniques, 2003

Background: The authors present their experience in the laparoscopic management of hepatic cysts and polycystic liver disease (PLD). Methods: Between January 1996 and January 2002, 16 patients underwent laparoscopic liver surgery. Indications were solitary giant cysts (n = 10) and PLD (n = 6). Data were collected retrospectively. Results: Laparoscopic fenestration was completed in 15 patients. Median operative time was 80 min. There was no deaths. Complications occurred in four patients: one patient with a solitary liver cyst experienced diarrhea, while a pleural effusion, a bleeding from the trocar-insertion site, and ascites occurred in three patients with PLD. Median follow-up was 34 months. There was one asymptomatic recurrence (11%) in one patient with a solitary cyst. Two patients with PLD had a symptomatic recurrence of a liver cyst. Conclusion: Laparoscopic fenestration could be the preferred treatment of solitary liver cysts and PLD. Adequate selection of patients and type of cystic liver together with a meticulous surgical technique are recommended.