Therapy of liver cysts – experience of the Department of Surgery, University Hospital in Pilsen 2009−2018

Abstract

Introduction: Liver cysts are present in about 5% of the population and are asymptomatic in most cases. Currently, liver cystic lesions are discovered arbitrarily during imaging assessments of the abdomen indicated for unrelated reasons. The final findings vary from solitary cysts to multiple lesions or eventually the polycystic liver disease which can result in liver transplantation. Most cases are congenital. In the case of a symptomatic manifestation, pressure pain in the upper right quadrant is the predominant symptom. The therapy is surgical; laparoscopic approach is preferred. Methods: A retrospective evaluation of the sample of 55 patients was conducted. The patients had been surgically treated at the Department of Surgery, University Hospital in Pilsen, from 01 Jan 2009 to 21 Dec 2017. The evaluation covered basic demographic data, the size of the dominant cyst, complications, hospitalization length, any relapse of the disease, etc. Results: In the presented period 62 surgeries of symptomatic liver cysts were performed, 55 of them by laparoscopy. The mean age of the patients was 61.7 years (32–83 years), women predominated (N=54, i.e. 87.1%). Complications occurred in 8 patients (12.9%); the most common was a bile leak. The mean length of hospitalisation was 4.5 days (2–20 days). In the follow-up period, 41 patients (66.1%) remained without any recidivism. Conclusion: Currently, the treatment of symptomatic liver cysts is laparoscopic, with fenestration being the standard approach. Due to potential complications centres with experience in liver surgery are prioritized.