Surgical treatment of symptomatic simple liver cysts

INTRODUCTION. Simple hepatic cyst (SHC) can cause symptoms due to compression of the surrounding structures. The aim of the present study was to evaluate symptoms, treatment, recurrence rate and post-operative complications of patients treated for symptomatic SHC. METHODS. Patients were identified from medical records. The inclusion criteria were symptomatic SHC, treatment with percutaneous aspiration or laparoscopic deroofing or both. Age, gender, symptoms, type of treatment, post-operative complications, recurrence of symptomatic liver cyst and time of symptomatic relief were recorded. RESULTS. A total of 66 patients were included. The most common symptom was abdominal discomfort and/or pain, which was reported in 88%. Nine patients received two, one received three and one received four cyst aspirations before further treatment or no recurrence of symptoms. A total of 84.7% had recurrence of symptoms after aspiration. Forty patients were treated with laparoscopic deroofing, 37 (92.5%) had relief of symptoms. Complications reported after cyst drainage was prolonged drainage (n = 1), dyspnoea (n = 1), bleeding (n = 2) and peritonitis (n = 2). After laparoscopic deroofing, the only post-operative complication was wound infection (n = 2). CONCLUSIONS. The present study showed that percutaneous aspiration of symptomatic SHC should be performed to ensure that the symptoms are related to the cyst. Laparoscopic deroofing has proven a definitive treatment for simple SHC and is associated with a low recurrence rate and few post-operative complications.