Liver Cysts

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

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

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

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

Patients should have a pre-operative CT

Patients should be discussed at an upper GI MDT

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

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

Mortality < 0.1%

Morbidity <15%

Recurrence rates <10 %

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