Liver Cyst (Hepatic Cyst) > Should I Worry If I Have a Liver Cyst?

Treatment of liver cysts

As a general rule, liver cysts are not treated unless symptomatic. This is especially done in simple cysts where the cyst is less likely to produce any symptoms throughout life. The exception to this rule is hydatid cysts and liver abscesses, since leaving them alone carries more risk of complications than their treatment. Hydatid cysts have a high probability of growth and rupture, which can cause jaundice, severe abdominal pain and can be potentially life-threatening if it ruptures into the abdominal cavity.

The main treatment lines for cysts are:

Surgical treatment

Surgical treatment is the main line of treatment of all cysts. The surgical methods, however, vary and simple cysts are treated in a completely different manner than hydatid cysts.

  • Simple cysts are treated by a procedure called “unroofing” which involves removing a portion of the cyst wall then leaving it as it is. Unroofing allows fluid to pass into the peritoneal cavity where it can be easily absorbed by the peritoneum (lining of the abdominal cavity). This procedure is usually done through laparoscopy nowadays.
  • Polycystic liver disease: In some cases, single cysts can be dealt with similarly in polycystic liver disease, but since their number is usually large, only symptomatic ones are managed as such and the rest are left alone. In some cases, an entire lobe of the liver can be removed with its cysts.
  • Hydatid cysts: Hydatid cysts should be managed carefully because their contents are toxic and can produce a severe allergic reaction if it leaks. That is why surgeons first aspirate such cysts before their removal. The cyst is then removed as a whole.
  • Neoplastic cysts: Neoplastic cysts are treated like all tumors with complete removal of the cyst and the surrounding tissue.
  • Liver abscesses: Liver abscesses are drained either with or without surgery. In most cases, antibiotics are attempted with drainage through the skin, and if fails, surgery is done.

Medical treatment

Medical treatment has a limited role in the management of liver cysts. Antibiotics are given in liver abscesses and some anti-parasitic medications such as mebendazole in hydatid cysts. Medical treatment of hydatid cysts is only given in patients unfit for surgery. Another procedure that may be attempted is called PAIR which means the aspiration of cyst contents then the injection lethal fluids to the parasite.

Written by Martin Davis