Fenestration in the management of simple hepatic cysts

Introduction: Simple hepatic cysts must be differenciated from cystadenoma and from cystadenocarcinoma. The treatment is different and surgical indications are restricted. We want to enhance the superiority of fenestration in the management of simple hepatic cysts through clinical cases and review of the literature. Observation: We report two cases of simple hepatic cyst the clinical presentation of which were pain and superinfection of the cyst. Initial diagnosis was made after ultrasonography and computed tomography scan. The first case was a recurrent cyst of segments IV-V, 3 years after a surgical drainage and was treated with aspiration, surgical drainage and alcohol sclerotherapy. Subcutaneous and intracystic abscesses occurred four months later treated with multiple percutaneous radiological drainage then with fenestration of the cyst and partial pericystectomy. The long-term outcomes was good. The second case was a huge cyst of the right lobe of the liver treated with fenestration with a good outcome. Conclusion: The diagnosis of simple hepatic cysts is easily done at radiology. Surgery is only indicated when the cyst is symptomatic or complicated. In these two cases, fenestration of the cyst was curative and it remains the recommended technique.