Nonparasitic liver cysts: different treatment strategies

Abstract

Objective The aim of this work was to study the clinicopathological data of nonparasitic liver cysts (NPLCs), its different management modalities, and outcome. Patients and methods This retrospective study included patients who were diagnosed as having NPLCs from January 2000 to the start of 2016. The clinicopathological data, surgical and nonsurgical treatment, and outcomes of these patients were studied. Results NPLC was present in 118 patients. There were 78 (66.1%) female patients and the median age was 48 years. The majority of cases (95; 80.5%) were of simple liver cysts and its management was conservative treatment with follow-up (51 patients; 53.7%), percutaneous aspiration, puncture aspiration injection and reaspiration or pig-tail catheter drainage (26 patients; 27.4%), and surgical treatment (18 patients; 18.9%) with either laparoscopic deroofing (12 patients) or open surgery (six patients). Six (5.1%) patients with intrahepatic biloma underwent percutaneous aspiration or pig-tail drainage. Five (4.2%) patients had cystadenoma and underwent resection or pericystectomy. Five (4.2%) patients had post-traumatic hematoma and underwent conservative treatment. Three (2.5%) patients had polycystic liver disease; one of them underwent laparoscopic deroofing of large ones and two patients underwent conservative treatment. Two (1.7%) patients had Caroli’s disease and were prepared for liver transplantation. Two (1.7%) patients had cysts with biliary atresia and underwent Kasai operation with excision of the cyst. Conclusion Most of the NPLCs are simple liver cyst that can be managed conservatively if it is asymptomatic and small, or with percutaneous radiological intervention or laparoscopic deroofing for large symptomatic or recurrent ones. Open or laparoscopic resection or pericystectomy is reserved for cystic neoplasms which is not common.