Results from the Types of Surgical Treatment for Hepatic Cyst

ABSTRACT

PURPOSE: Symptomatic and/or malignant changes in hepatic cysts require surgical treatment, but there are few comparative studies with respect to the safety and long-term effectiveness. We compared the resection and non-resection of hepatic cysts from the view point of recurrence and complications. METHODS: We reviewed 24 patients who underwent surgery for hepatic cysts between 1990 and 2001 at a single institution. There included 15 resections and 9 non-resections. RESULTS: The median age was 59 years, with a male to female sex ratio of 9 15. The median size of the dominant cyst was 12 cm, and 22 patients presented with symptoms. We treated 12 simple cysts, 3 polycystic liver diseases (PCLD), 3 cystadenomas, 1 cystadenocarcinoma, 2 hamartomas, 1 hydatid cyst, 1 traumatic cyst and 1 other. The causes requiring an operation were peritoneal irritation in 7, a mass effect such as early satiety or jaundice in 5, possible malignancy in 4, associated hepatobiliary diseases in 3, increase of cyst sizes in 2 and another disease in 2. We performed 5 right lobectomies, 2 left lobectomies, 1 left lateral segmentectomy, 3 non-anatomical resections, 3 cyst excisions, and 1 total hepatectomy for liver transplantation in the resection group. 6 unroofings and 3 fenestrations were performed in the non-resection group, in which a laparoscopic approach was applied in 3 cases. The incidence of postoperative complications were uncommon in both groups, whereas resection decreased the recurrence rate significantly (P=0.003). CONCLUSION: Resection is a safe and effective procedure to lower the recurrence of all cystic lesions in the liver.