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

Česká verzia

Authors: J. Fichtl; V. Třeška; J. Vodička; T. Skalický; V. Liška
Authors place of work: Chirurgická klinika Fakultní nemocnice Plzeň, Lékařská fakulta v Plzni, Univerzita Karlova
Published in the journal: Rozhl. Chir., 2019, roč. 98, č. 10, s. 404-407.
Category: Original articles

Summary

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.

Keywords:

diagnosis – non-parasitic liver cyst

Zdroje

1. Bara T, Bancu S, Mureşan M, et al. Polycystic liver disease with complications: fenestration by laparoscopic approach. Chirurgia (Bucur) 2012;107:791−5.

2. Asuquo M, Nwagbara V, Agbor C, et al. A. Giant simple hepatic cyst: a case report and review of relevant literature. Afr Health Sci. 2015;15:293−8. doi: 10.4314/ahs.v15i1.40.

3. Simon T, Bakker IS, Penninga L, et al. Haemorrhagic rupture of hepatic simple cysts. BMJ Case Rep. 2015;19. pii: bcr2014208676. doi: 10.1136/bcr-2014-208676.

4. Imaoka Y, Ohira M, Kobayashi T, et al. Elective laparoscopic deroofing to treat the spontaneous rupture of a large simple liver cyst: a case report. Surg Case Rep. 2016;2:148. doi: 10.1186/s40792-016-0275-x.

5. Jung DH, Hwang S, Ahn CS, et al. Fenestration of liver cysts in polycystic liver disease to improve quality of life: a case report and literature review. Korean J Hepatobiliary Pancreat Surg. 2015;19:40−6. doi: 10.14701/kjhbps.2015.19.1.40.

6. Doussot A, Gluskin J, Groot-Koerkamp B, et al. The accuracy of pre-operative imaging in the management of hepatic cysts. HPB (Oxford) 2015;17:889−95. doi:10.1111/hpb.12443.

7. Scheuerlein H, Rauchfuss F, Franke J, et al. Clinical symptoms and sonographic follow-up after surgical treatment of nonparasitic liver cysts. BMC Surg. 2013;13:42. doi: 10.1186/1471-2482-13-42.

8. Stănescu CA, Păduraru DN, Cirimbei C, et al. The laparoscopic management of simple hepatic cysts. J Med Life. 2015;8:342−5.

9. Igami T, Tsuchiya T, Ebata T, et al. Application of a z-shaped umbilical incision and a saline-cooled radiofrequency device to single-incision laparoscopic surgery for a huge liver cyst: Report of a case. Int Surg. 2015;100:1098−103. doi: 10.9738/INTSURG-D-14-00198.1.

10. Kashiwagi H, Kawachi J, Isogai N, et al. Scarless surgery for a huge liver cyst: A case report. Int J Surg Case Rep. 2017;39:328−31. doi: 10.1016/j.ijscr.2017.08.053.

11. Dinc B, Mesci A, Dinc SE, et al. A giant simple liver cyst that caused increases in serum CA 19-9 and CA 15−3 Levels. J Clin Med Res. 2014;6:487−9. doi: 10.14740/jocmr1950e.

12. Chen YW, Li CH, Liu Z, et al. Surgical management of biliary cystadenoma and cystadenocarcinoma of the liver. Genet Mol Res. 2014;25:6383−90. doi: 10.4238/2014.

13. Frider B, Larrieu E. Treatment of liver hydatidosis: how to treat an asymptomatic carrier? World J Gastroenterol. 2010;7:4123−9. doi: 10.3748/wjg.v16.i33.4123.

14. Vávra P, Třeška V, Ostruszka P, et al. Chirurgické řešení komplikované jaterní echinokokózy u dvou bulharských občanů na dvou pracovištích v České republice. Rozhl Chir. 2012;91:381−7.