Liver Cysts

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Definition- Simple hepatic cyst is a biliary malformation, which does not have communication with the intrahepatic biliary tree with a 5% incidence in adult population

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Asymptomatic simple liver cysts, even when large, do not require treatment or surveillance

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Symptomatic liver cysts require treatment (pain/spontaneous bleed events/biliary obstruction)

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Prior to treatment hydatid cyst should be ruled out in all cases before the operation by serology

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Patients should have a pre-operative CT

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Patients should be discussed at an upper GI MDT

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Any features to suggest a diagnosis other than simple liver cyst disease should by referred to a resectional liver centre

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Laparoscopy de-roofing should be considered as the primary treatment of choice

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Mortality < 0.1%

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Morbidity <15%

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Recurrence rates <10 %

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Due to high recurrence rates, management by aspiration followed by sclerotherapy should be reserved for those patients who are not eligible for surgery and general anaesthesia