Clinical Treatment Of Hepatic Cysts: Analysis Of 137 Cases

Objective:To compare laparoscopic fenestration, laparotomy fenestration and ultrasound-guided puncture drainage with Alcohol injection and sclerosing in the treatment for liver cyst and explore their advantages, disadvantages, indications and contraindications, to find a reasonable way of surgical treatment of hepatic cyst.Methods:Review a total of 137 cases of liver cyst hospitalized at the Shandong University Qilu Hospital right from February 2006 to June 2009, were treated by laparotomy fenestration (21 cases), laparoscopic fenestration (52 cases), and puncture drainage with Alcohol injection and sclerosing (64 cases). The operative time, blood loss, hospitalization time, hospitalization costs, surgical complications and recurrence rate were analyzed to compare the advantages and disadvantages of three surgical methods.Results:52 patients received laparoscopic fenestration, no conversion to laparotomy patients, no operative mortality, postoperative pleural effusion in 2 cases,1 case of bile leak,1 case of ascites, recovered after conservative treatment, three cases of recurrence.21 received laparotomy fenestration, no mortality,1 patient developed postoperative pleural effusion,1 case of ascites, and 2 cases of recurrence.64 receved ultrasound-guided puncture drainage with Alcohol injection and sclerosing, no operative mortality,6 patients had symptoms of intoxication,2 cases of postoperative drainage loss,10 cases recurrence in 2-6 months after surgery. Operative time and blood loss were significantly higher than the endoscopic and laparotomy group, P <0.05; hospitalization time of laparotomy group was longer than the other two groups, P<0.05, sclerosis group was shorter than the other two groups, P<0.05; postoperative complications of three groups had no significant statistical difference, P> 0.05; hospitalization costs of laparoscopy and laparotomy was no significant difference, P> 0.05, sclerosis group was less than other groups, P<0.05; recurrence rate of sclerosis group was higher than in the other two groups P<0.05, but the laparotomy group and the laparoscopic group had no significant difference, P> 0.05.Conclusion:The three kinds of commonly used clinical treatment for hepatic cyst methods have respective advantages and disadvantages. With liver cysts needed surgical treatment, we must strictly control the surgical indications and contraindications, comprehensively evaluate the location, size, shape of cyst, cyst fluid properties, liver functions, and the body situation, and choose the best treatment.