Analysis Of Surgical Treatment For Simple Hepatic Cysts And Polycystic Liver Disease (105 Cases Report)

Objective:This study was going to discuss the choices of therapy,clinical advantages and shortages of all therapies for simple hepatic cysts and polycystic liver disease.Methods:Retrospective analysis was performed in 105 hepatic cyst cases in PUMC Hospital from February 1994 to January 2008.The average of the 105 patients was 59.56 years old.Female patients(71.43%) were more than male patients.There were 64 simple hepatic cyst cases,26 single cyst cases,and 38 polycystic cases.Forty-one cases were polycystic liver disease,in which 17 cases combined with polycystic renal disease,1 case with pancreatic cyst,and 1 case with ovarian cyst.In the single cyst group of simple hepatic cyst cases,the cyst in 16 cases located in the right lobe of the liver,10 cases in the left lobe of the liver.The cysts in polycystic group of simple hepatic cyst cases and polycystic liver disease cases located in both lobe of the liver.Eleven cases received percutaneous cyst drainage combined with injection of sclerosis agent.Thirty-four cases received laparoscopic cyst fenestration.Fifty cases received laparotomy for cyst fenestration.Ten cases received cyst fenestration combined with partial hepatic resection.Results:All the 105 cases released from their pre-operative symptoms.The regression rate was 100%.Fifty-three cases were followed up.Twelve cases were found symptom recurrent.In single cyst group of simple hepatic cyst cases,the symptom recurrence rate was 0%in patients received either percutaneous cyst drainage combined with injection of sclerosis agent treatment,or in patients received laparoscopic fenestration treatment,or in patients received cyst fenestration operation by laparotomy.There was 1 case recurrence detected by imagnological method(9.09%).The recurrence rate in partial liver resection group was 0%.No cyst recurrence was found by imaging examination(0%).In the polycystic group of simple hepatic cyst cases,cyst recurrence was found in 1 case treated by percutaneous cyst drainage and sclerosis agent injection(33.33%),1 case treated by laparoscopic fenestration(6.67%),and 1 case treated by laparotomic fenestration(6.67%). No recurrence was found in patients treated with fenestration and partial hepatectomy (0%).In the polycystic liver disease group,symptom recurrence was found in 2 cases treated by percutaneous cyst drainage and sclerosis agent injection(40%),4 cases treated by laparoscopic fenestration(36.4%),2 cases treated by laparotomic cyst fenestration (11.11%),and 1 case treated by fenestration and partial hepatectomy(33.33%).Conclusion:The therapeutic strategy for simple hepatic cysts and polycystic liver disease should be individualized.The treatment choices in one case vary during different stage of the disease.The treatment choices for polycystic group of simple cyst and polycystic liver disease are similar,but the long term effect is not ideal by commonly used therapy.