Background: The non-parasitic simple cysts of the liver are cystic formations, containing a serous fluid, not comminicating with the intrahepatic biliary tree. Rarely, they become symptomatic in fewer than 5% of patients and require intervention. Treatment of hepatic simple cyst that cause symptoms can be surgical or non-surgical. Nonsurgical treatment mainly consists of percutaneous ultrasono-guided aspiration of the cyst contents, followed by injection of a number of sclerosing agents (alcohol, minocycline or tetracycline) into the cyst. Surgical treatment consists of various procedures such as simple fenestration, complete unroofing with or without omental flap, enucleation or formal hepatic resections. But recently conventional surgery is replaced by laparoscopic surgery. First laparoscopic cyst unroofing was published in 1991.
Purpose: As a result of the low incidence of this disease, there is no consensus about the treatment of choice or the indications for each method. So we tried to compare the results of each treatment methods including percutaneous aspiration and sclerosing therapy, conventional unroofing surgery and laparoscopic unroofing surgery.
Methods: Between Nov.1990 and Nov.1999, We studied total 12 cases except 2cases which was missed during follow-up period among 14 cases. They (12 cases) were treated by various methods including sclerosing therapy (8 cases), conventional surgery (3 cases) and laparoscopic surgery (4 cases). Their clinical records were reviewed retrospectively.
Results: 5 cases among 8 cases, which were done by sclerosing therapy, had recurrences. Four patientsamong all 12 cases that were treated by surgical intervention underwent laparoscopic unroofing for symptomatic huge simple cysts. There was no morbidity or mortality laparoscopic wide unroofing.
Conclusion: Laparoscopic unroofing of hepatic cysts may be a safe and effective procedure. It produces minimal surgical trauma, shorter hospital stay and avoids the morbidity of laparotomy. Laparoscopic cyst unroofing will probably become the methods of choice for the treatment of symptomatic liver cysts including recurrent cases after percutaneous alcohol sclerosing therapy.
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