Contemporary Management of Hepatic Cyst Disease: Techniques and Outcomes at a Tertiary Hepatobiliary Center

Gomez, Axel; Wisneski, Andrew D.; Luu, Hubert Y.; Hirose, Kenzo; Roberts, John P.; Hirose, Ryutaro; Freise, Christopher E.; Nakakura, Eric K.; Corvera, Carlos U.

doi:10.1007/s11605-020-04821-1

Cited by 15 publications

(14 citation statements)

References 35 publications

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“…And determine the specific operation method according to the results of intraoperative medical examination and the nature of the fluid in the capsule. 13,14 Puncture and drainage Liver cyst puncture and drainage can only temporarily relieve the symptoms of compression caused by giant cysts, cysts usually recur shortly after drainage has ended. 11 Not as a recommended treatment for congenital liver cysts.…”

Section: Hepatic Cystectomymentioning

confidence: 99%

Current status and progress in the treatment of congenital liver cyst

Chaoxing

Gong

2021

Int Surg J

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Liver cyst is a relatively common benign liver disease. According to the cause of the disease, it can be divided into two types: non-parasitic liver cyst and parasitic liver cyst. Congenital liver cyst is the most common non-parasitic liver cyst in clinical practice, also known as true cyst, which mainly include simple liver cyst and polycystic liver diseases (PLD). In recent years, with the popularization of ultrasound and other examinations, the detection rate of liver cyst has increased year by year, but there is no unified consensus on the treatment of liver cysts. This article reviews the conservative treatment, puncture drainage, aspiration sclerotherapy, surgical treatment and other treatment options for congenital liver cysts, as well as the technological progress in recent years.

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Section: Hepatic Cystectomymentioning

confidence: 99%

Current status and progress in the treatment of congenital liver cyst

Chaoxing

Gong

2021

Int Surg J

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“…For nonsurgical management, percutaneous aspiration, sclerotherapy, and internal drainage are often used[ 8 , 9 ]. Surgical treatment mainly includes unroofing, cyst fenestration, hepatectomy, and open or laparoscopic liver transplantation[ 11 ]. Treatment selection depends on cyst location, size, surroundings and other factors[ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Percutaneous aspiration and sclerotherapy of a giant simple hepatic cyst causing obstructive jaundice: A case report and review of literature

He¹,

Sun²,

Lü³

et al. 2022

WJGS

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BACKGROUND Giant simple hepatic cysts causing intrahepatic duct dilatation and obstructive jaundice are uncommon. A variety of measures with different clinical efficacies and invasiveness have been developed. Nonsurgical management, such as percutaneous aspiration and sclerotherapy, is often applied. CASE SUMMARY The case is a 39-year-old female with a 5-mo history of cutaneous and scleral icterus, loss of appetite, and dark urine. Lab tests showed jaundice and liver function abnormalities. Imaging revealed a giant simple hepatic cyst obstructing the intrahepatic bile ducts. A combination of percutaneous catheter aspiration and lauromacrogol sclerotherapy was successfully performed and the effects were satisfactory with the size of cyst decreasing from 13.7 cm × 13.1 cm to 3.0 cm × 3.0 cm. Further literature review presented the challenges of managing giant simple hepatic cysts that cause obstructive jaundice and compared the safety and efficacy of a combination of percutaneous aspiration and lauromacrogol sclerotherapy with other management strategies. CONCLUSION Giant simple hepatic cysts can cause obstructive jaundice, and a combination of percutaneous catheter aspiration and sclerotherapy with lauromacrogol are suggested to treat such cases.

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“…Most patients with liver cysts are asymptomatic, while cysts are usually accidental during imaging examinations. The general recommendation for such patients is clinical observation without any intervention ( 3 ). Only some patients exhibit the symptoms, mostly originating from the cyst’s compression to the surrounding tissues.…”

Section: Introductionmentioning

confidence: 99%

Unexpected discovery of intrahepatic cholangiocarcinoma during follow-up in two cases of liver cysts: cases report

Liu¹,

Li²,

Ya³

et al. 2022

Transl Cancer Res TCR

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Background: The liver cyst is commonly treated by hepatobiliary surgery. Generally, most patients show no apparent symptoms and often get diagnosed accidentally during the imaging examinations. In addition, most patients with liver cysts follow a benign course, with fewer severe complications and rare occurrences of malignant changes. Therefore, based on disease characteristics and healthcare costs, long-term regular follow-up of liver cysts are rarely performed clinically.Case Description: Here, we reported two previously treated or observed cases for liver cysts, where intrahepatic neoplastic lesions were found unexpectedly at the liver cyst during follow-up. These two patients' clinical manifestations and laboratory examinations lacked specificity with unclear pre-operative diagnosis, whereas the post-operative pathology confirmed cholangiocarcinoma. One of the patients was a 64-year-old female with right upper abdominal distension. She underwent cyst fenestration for a liver cyst 3 years ago. In the latest admission, imaging examination revealed a tumor in the left inner lobe of the liver. The tumor was located in the exact fenestration location, and the pathological diagnosis of cholangiocarcinoma was made after surgical resection. The patient received Lenvatinib post-operatively and had no recurrence during the follow-up. Another patient, a 68-year-old woman, was asymptomatic, but the liver margin was palpable under the ribs on her physical examination. She had a previous diagnosis of liver cysts and was on regular yearly follow-up. In the last follow-up, a tumor was found close to a cyst. It was diagnosed as intrahepatic cystadenocarcinoma before surgery; however, the pathological features after surgical resection were more consistent with the cholangiocarcinoma. The patient had lung metastases 2 months after the surgery, but her condition improved after receiving targeted therapy and immunotherapy.Moreover, she is alive to this day. Conclusions:We reported 2 cases of intrahepatic cholangiocarcinoma discovered accidentally during the follow-up of hepatic cysts. The location of the malignant tumor coincided with the location of the cyst, making the clinical differential diagnosis problematic. Therefore, it is necessary to be vigilant about the possibility of combined malignant tumors for the follow-up of complex cysts, as early detection and treatment may help improve the prognosis of these patients. After surgery, multimodal therapy, including chemotherapy, immunotherapy, and targeted therapy, is helpful.

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Contemporary Management of Hepatic Cyst Disease: Techniques and Outcomes at a Tertiary Hepatobiliary Center

Cited by 15 publications

References 35 publications

Current status and progress in the treatment of congenital liver cyst

Current status and progress in the treatment of congenital liver cyst

Percutaneous aspiration and sclerotherapy of a giant simple hepatic cyst causing obstructive jaundice: A case report and review of literature

Unexpected discovery of intrahepatic cholangiocarcinoma during follow-up in two cases of liver cysts: cases report

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