Surgical alternatives for the treatment of nonparasitic liver cysts

Four cases of nonparasitic liver cysts treated with different operative procedures are presented. Asymptomatic small cysts need not be treated. Moderate-sized cysts require treatment based on the presence or absence of infection. Infected cysts must be drained externally via catheters or by marsupialization. Noninfected cysts may be adequately drained internally through partial cyst wall excision or unroofing. Large bile-containing cysts are best drained internally using a Roux-en-Y cystojejunostomy.