Symptomatic non-parasitic cysts of the liver

Abstract

Abstract Eighteen patients with symptomatic non-parasitic cysts of the liver were seen and treated at the Lahey Clinic Foundation between 1950 and 1970. A review of the world literature indicates that the incidence of non-parasitic cystic disease of the liver is undoubtedly higher than is indicated by the number of clinically diagnosed cases. No specific symptom complex was observed. When symptoms do eventually occur they are almost always, in the absence of complications, the result of the space-occupying effect of the cyst either on the liver itself or on adjacent viscera. When biochemical studies of liver function are abnormal it is the result of coincidental or associated liver disease and not of the cyst itself. Although cystic disease of the liver is rarely diagnosed clinically, the possibility should be seriously considered in any patient with an enlarged liver that is associated with few symptoms and little or no impairment of hepatic function. Although radio-isotope scanning and coeliac axis arteriography are being used with increasing frequency and may be of value in the evaluation of this entity, the diagnosis at the present time depends on exploratory laparotomy. The safety of surgery in this series, together with the excellent long-term results, supports our view that symptomatic cysts of the liver should be treated surgically; whenever possible the lesion should be removed by either local excision or formal hepatic resection. In view of this, the authors feel that the management of such cases should only be undertaken by those familiar with the techniques of hepatic resection.