title: Surgical management of cystic lesions in the liver.
abstract: BACKGROUND
  Liver cysts are common, occurring in up to 5% of the population. For many types of cysts, a variety of different treatment options exist and the preferred management is unclear.
  
  
  METHODS
  A Pubmed and Medline literature review using key words non-parasitic hepatic cysts, polycystic liver disease, echinococcus, hydatid cysts parasitic cysts, Caroli's disease, cystadenoma; liver abscess, surgery, aspiration and treatment was undertaken and papers pertaining to the diagnosis and management of cystic lesions within the liver were retrieved.
  
  
  RESULTS
  Asymptomatic simple cysts in the liver require no treatment. Therapy for symptomatic cysts may incorporate aspiration with sclerotherapy or de-roofing. At present, insufficient evidence exists to recommend one over the other. Polycystic liver disease presents a unique management problem because of high morbidity and mortality rates from intervention and high rates of recurrence. Careful patient counselling and assessment of symptom index is essential before embarking on any treatment. New medical treatments may ameliorate symptoms. Acquired cystic lesions in the liver require a thorough work-up to fully characterize the abnormality and direct appropriate treatment. Hydatid cysts are best treated by chemotherapy followed by some form of surgical intervention (either aspiration and sclerotherapy or surgery). Liver abscesses can effectively be treated by aspiration or drainage. With improved antimicrobial efficacy, prolonged treatment with antibiotics may also be considered.
  
  
  CONCLUSIONS
  All patients with cystic lesions in the liver require discussion at multi-disciplinary meetings to confirm and the diagnosis and determine the most appropriate method of treatment.
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, University Hospitals of Leicester, Leicester, UK. gg43@le.ac.uk
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Garcea
authors.forename: Arumugam
authors.initials: A
authors.lastname: Rajesh
authors.forename: Ashley R
authors.initials: AR
authors.lastname: Dennison
mesh_terms: D003560:Cysts / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D004322:Drainage; D006498:Hepatectomy; D006801:Humans; D008107:Liver Diseases / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D018579:Patient Selection; D015911:Sclerotherapy