title: Liver resection for cystic lesions: a 15-year experience.
abstract: OBJECTIVE
  The aim pf this paper was to review the management strategies in patients who had hepatic resection for cystic lesions. If symptomatic, a simple liver cyst (SC) is best treated by unroofing. A hydatid cyst (HC) is treated by simple cystectomy or pericystectomy. Many procedures have been described for the management of complex non-HCS including aspiration, sclerosing therapy, drainage, unroofing, and resection.
  
  
  METHODS
  A retrospective review of patients who had liver resection for cystic lesions between January 1, 1992, and December 31, 2006. The study was carried out at a University Hospital and a General Community Hospital affiliated with a University program. Management strategies were detailed, including clinical, biological, and imaging features. Operative morbidity and mortality as well as long-term outcome were also assessed. A comparison between preoperative and postoperative diagnoses was performed.
  
  
  RESULTS
  Thirty-three patients (24 women and 9 men) underwent 39 liver resections, including 14 left lateral resections, 12 right hemi-hepatectomies, 7 left hemi-hepatectomies and 6 segmentectomies or wedge resections. The final diagnosis included hydatid cyst in 10 patients (30%), cystadenoma in 6 (18%), simple cysts in 6 (18%), Caroli's disease in 4 (12%), cystadenocarcinoma in 3 (9%) and miscellaneous in the 4 remaining (12%). There was no mortality and the postoperative morbidity rate was 15%. Long-term follow-up revealed that, besides patients with malignancies whose outcome was dismal, overall prognosis was positive with efficacious symptom control. CONCLUSION; Accurate preoperative diagnosis of liver cystic lesions may be difficult. However, liver resection for such lesions is a safe procedure that provides long-term symptomatic control in benign disease and may be curative in cases of underlying malignancy. Even if nearly 50% of liver cystic lesions treated by resection were either symptomatic SC or HC, we recommend en-bloc liver resection for all liver cystic lesions that are not clearly parasitic or simple cysts.
authors.affiliation: Department of General Surgery, Hospital Center of Poissy, Poissy, France. elie.chouillard@chi-poissy-st-germain.fr
authors.forename: E
authors.initials: E
authors.lastname: Chouillard
authors.forename: A
authors.initials: A
authors.lastname: Gumbs
authors.forename: P
authors.initials: P
authors.lastname: Fangio
authors.forename: A
authors.initials: A
authors.lastname: Torcivia
authors.forename: C
authors.initials: C
authors.lastname: Tayar
authors.forename: A
authors.initials: A
authors.lastname: Laurent
authors.forename: A
authors.initials: A
authors.lastname: Dache
authors.forename: J C
authors.initials: JC
authors.lastname: Lacherade
authors.forename: J Tran
authors.initials: JT
authors.lastname: Van Nhieu
authors.forename: D
authors.initials: D
authors.lastname: Cherqui
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003536:Cystadenocarcinoma / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors