title: Management of nonparasitic hepatic cysts.
abstract: BACKGROUND
  The optimal management of nonparasitic hepatic cysts (NPHC) is a topic of debate. The purpose of this study was to evaluate our 17-year experience with NPHC.
  
  
  METHODS
  From January 1990 to August 2007, 131 consecutive patients with NPHC were evaluated and treated at our institution. Seventy-eight patients (60%) had simple hepatic cysts (SHC). The remaining 53 (40%) had polycystic liver disease (PLD). Morbidity, mortality, and recurrence rates for each of the two groups were evaluated.
  
  
  RESULTS
  Thirty-seven patients underwent open deroofing (SHC, 24; PLD,13), 66 had laparoscopic deroofing (SHC, 46; PLD, 20), 19 had percutaneous drainage (SHC, 4; PLD, 15), 3 had major hepatic resections (PLD, 3), 4 had cystojejunostomy (SHC, 4), and 2 had combined hepatorenal transplantation (PLD, 2). Corresponding morbidity, mortality, and recurrence rates were, respectively: conventional deroofing: SHC, 29%, 0%, 8%; PLD, 8%, 0%, 0%; laparoscopic deroofing: SHC, 2%, 0%, 2%; PLD, 25%, 0%, 5%; percutaneous drainage: SHC, 0%, 0%, 75%; PLD, 0%, 0%, 20%; cystojejunostomy: SHC, 75%, 0%, 25%; major hepatic resections: PLD, 66%, 0%, 0%; and hepatorenal transplantation: PLD, 50%, 50%, 0%.
  
  
  CONCLUSIONS
  Laparoscopic deroofing provided complete relief of symptoms for both SHC and PLD. Percutaneous drainage was our procedure of choice for infected liver cysts and potentially for patients who cannot tolerate general anesthesia. Liver and liver-kidney transplantations were reserved for patients with end-stage PLD alone and in association with end-stage renal disease, respectively.
authors: Hepato-Pancreatico-Biliary and Liver Transplantation Units, Department of General Surgery, Hospital Italiano, Buenos Aires 1181, Argentina.
authors: Oscar M
authors: OM
authors: Mazza
authors: Diego L
authors: DL
authors: Fernandez
authors: Juan
authors: J
authors: Pekolj
authors: Guillermo
authors: G
authors: Pfaffen
authors: Rodrigo
authors: R
authors: Sanchez Clariá
authors: Ernesto P
authors: EP
authors: Molmenti
authors: Eduardo
authors: E
authors: de Santibañes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003560:Cysts / Q000601:surgery*; D004322:Drainage; D005260:Female; D006498:Hepatectomy; D006801:Humans; D010535:Laparoscopy; D008107:Liver Diseases / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged