[Treatment strategy in non-parasitic benign cysts of the liver]

The authors present the problems of treatment of benign non-parasitic cystic liver diseases. Recent diagnostic and treatment strategy is demonstrated at the cohort of 25 patients (16 women and 9 men), who were operated on Department of Surgery, Medical School and Teaching Hospital Pilsen, Charles University Prague between years 2002-2007. The average age was 59.9 years (38-86 years). We performed 15 laparoscopic fenestrations, 5 opened fenestrations, three enucleations of cysts and one left lobectomy and one central liver resection. The resections were performed because of diagnostic uncertainty to verify histological character of leasions at patients after previous operation of gastrointestinal tract for malignancy. Histological diagnosis was proved in 16 cases solitary liver cyst, in 7 cases of polycystic liver disease, one biliary cystadenoma and one retentive cyst. The reoperation of symptomatic solitary liver cyst was performed in one patient after 12 months from primary operation. The average follow-up of patients after surgical treatment was 41 months (5-96 months). Solitary liver cysts are indication to laparoscopic fenestration with biopsy in case of evidence of symptoms. Polycystic liver diseases are treated conservative and surgical treatment is indicated at outstanding and apparent symptomatology of this disease, where is possible to demonstrate preoperatively one or more dominant cysts.