| Background:With the development of imaging technology and the consciousness of the people,the incidence of simple hepatic cysts(SHC)is increasing.More and more patients with SHC intend to take a surgery for the lesion.During the examinations of these patient,we find the tumor maker of Carbohydrate Antigen 19-9,which is usually used as a diagnostic marker for malignant tumors,is sometimes elevated in serum and/or the liquid in cysts.Objective:To investigate the epidemiology and characteristics of SHC,as well as the effectiveness of different treatment approaches for it.At the same time,the significance of serum or fluid Carbohydrate Antigen 19-9 expression,is evaluated.Method:A retrospective analysis of 190 patients with SHC who were treated by surgery in Qilu hospital from February 2009 to February 2017 was performed.Among these 190 patients,there were 69 males(36.32%),with the average age 58.38±10.80,and the other 121 patients were females(63.68%),with the average age of 58.86±11.38.In all of these patients,91cases are symptomatic,such as abdominal distention,abdominal pain,jaundice,vomit,fever and so on.On the other hand,34 cases had gallstone,gallbladder polyp,hepatic hemangioma and chronic viral hepatitis Bothered.There were 23 hepatic multicyst cases and 167 isolated SHC cases.Among the 167 isolated SHC cases,4 cases were in the segment I,94 cases were located in the right lobe of liver,and the other 69 cases were located in the left lobe.Result:26 male and 65 female patients arise symptoms,the difference between male and female was significant(P=0.033).24 cases had serum CA19-9 elevated,and the level of serum CA19-9 was correlated with the age,diameter of cyst and volume of cyst fluid.43cases had fluid CA19-9 elevated,and its level had no correlation with the factors mentioned above.11 cases had receipted the laparotomy,with an average surgical time of 101.91±8.89min and an average hospital stay time of 7.55±1.30days.171 cases received the laparoscopy fenestration with the average surgical time of 41.14±5.43min and average hospital stay time of 3.40±0.97days.The difference of average surgical time and hospital stay time between these two groups was significant(P<0.01).All of these cases were followed up for 90 days.None of the 11 cases that underwent laparotomy recurred,while 10 patients of the laparoscopy fenestration group had cysts detected again by CT or US examination,and 1 recurrent case had the symptom.The difference of recurrence rate between these two groups had no statistical significance.The pathology result of all cases were benign,and the serum or liquid CA19-9 level had no relationship with it(P>0.05).Conclusion:The SHC used to occur in the patients older than 40,with a female predominance,and the symptoms were more common in females.There is a positive correlation between the serum CA19-9 and the age,the diameter of cyst,while the fluid CA19-9 level in cyst has no correlation with the above-mentioned factors.Elevated CA19-9 level did not indicate the malignancy of the cycst.Laparoscopy fenestration should be the best treatment choice for hepatic cys,because of less trauma and low recurrence rate. |
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