Experience with different methods of treatment of nonparasitic liver cysts.
OBJECTIVE
In a search for the optimal management of nonparasitic liver cysts, a study was made of the effectiveness of different methods.


METHODS
Between 1 January 1982 and 15 December 2001 we treated 132 patients with nonparasitic liver cysts. In 72 patients 31 cysts were treated with enucleation, 60 with deroofing, and 24 with stitching by laparotomy; two liver resections were also performed. In a further 34 patients 36 cysts were treated with deroofing by minimally invasive surgery. In an additional 26 patients 32 cysts were treated with various interventional radiological methods.


RESULTS
There was no mortality. The morbidity rate after laparotomy was significant (22.2%). The rate of recurrence after enucleation and deroofing was 6.5% and 13.8%, respectively, but there were no recurrences after stitching and liver resection. The recurrence rate following laparoscopic deroofing was 19.4%, and that following interventional radiological procedures was 50%.


CONCLUSIONS
Treatment is required only if cysts are highly symptomatic or if growth is detected. Interventional radiological methods do not prove more favorable than surgery. Laparoscopic fenestration is preferred because of its low morbidity and the short period of hospitalization. Traditional surgical methods should be reserved merely for cases in which laparoscopic deroofing is not feasible.
Petri
András
A
Department of Surgery, Faculty of Medicine, University of Szeged, Pécsi u. 4, 6720 Szeged, Hungary. pa@surg.szote.u-szeged.hu
Höhn
József
J
Makula
Eva
E
Kókai
Erzsébet László
EL
Savanya
Gábor Kocsis
GK
Boros
Mihály
M
Balogh
Adám
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003560:Cysts / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D004322:Drainage / Q000379:methods; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008107:Liver Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015642:Radiology, Interventional; D025321:Surgery, Computer-Assisted